What is ADHD? Are You a Hunter in a Farmer's World?
Sometimes someone comes along who takes a body of knowledge & moves it into a new vision of hope & encouragement -- I hope I've done that for everyone who knows they're a hunter in a farmer's world...
Back in 1979, I thought I understood attention deficit hyperactive disorder, or ADHD.
It wasn’t called ADHD back then – instead we used the labels of hyperactivity, hyperkenisis, The Hyperactive Syndrome, Minimal Brain Damage, and Minimal Brain Dysfunction, but the criteria were the same: distractibility, impulsivity, a need for high levels of stimulation, and, when including hyperactivity, the inability to sit still in a boring environment.
But, nonetheless, I thought I understood it. I was the executive director of a residential treatment facility in New Hampshire and virtually every child ever referred to us had carried in his or her paperwork one of the those labels. I’d attended seminars and trainings on hyperactivity, and myself had trained foster parents and child-care workers in how to work with hyperactive and difficult children. I spent half a year organizing and supervising a study of the Feingold Diet in our facility to determine if it would help hyperactive children, and published the results of that study in the October, 1980 issue of The Journal of Orthomolecular Psychiatry. I was a consultant to other facilities and board member of The New Hampshire Group Home Association. I did radio spots on how to discipline children, which ran as public service announcements all over New England. I thought I understood what we now call ADHD.
But apparently I didn’t understand it as well as I thought.
In 1989, at the age of 12, our middle child “hit the wall” in school. Most parents of ADHD children – or adults with ADHD – know exactly what hitting the wall means. It’s where a child has been faking it their entire academic life, paying attention twenty percent of the time (more or less), and somehow managing to pull a rabbit out of the hat at exam time. There are warning signs – extreme unevenness in their grades (they do spectacularly in those classes where they’ve bonded to the teacher, but poorly in those where they haven’t, regardless of how difficult the subject may be); last-minute work; constant reports of lost or missing papers and homework; a wounded expression crossing his face whenever the topic of school was brought up. But my wife, Louise, and I had managed to miss all of these. And now our son was in danger of failing one or two of his seventh grade classes.
Not recognizing ADHD in our own child, we took him to a psychologist who specialized in educational testing. “Nuke him,” I said. “Give him every test you have. Rorschach, MMPI, IQ tests – everything. I want to know if he has some sort of problem or learning disability that we’ve completely overlooked. Even ask him about drug use and how life is in school – maybe there’s something going on that he’ll share with you but has been hiding from us.” We left Justin with the fellow and went out to do a half-day’s errands.
When we returned, the psychologist brought Justin out and sat him down in an office with Louise and me on either side of him. He stood in front of us and spoke to Justin. “I can see from your tests, young man, that you’re very bright,” he said. “In fact, you’re probably smarter than your IQ tests indicated, because the first thing these tests measure is a person’s ability to take a test...and the condition you have makes it hard for you to take tests.”
“Condition?” Justin and I said at the same moment.
“Well, yes,” the man said. “You have a brain disorder called attention deficit disorder, or ADD.”
Justin’s eyes boggled.
“And it’s probably hereditary,” the man added, causing me to sit up and take personal notice.
He then went on to tell us some useful and not-useful stories about ADHD. Here’s a summary of what he told us was known then (and is largely the state of knowledge today):
What ADHD is
ADHD is characterized by three primary behaviors (sometimes referred to as “the three-legged stool”), those being distractibility, impulsivity, and stimulation-seeking behaviors.
Distractibility is a sort of scanning activity, where the child (or adult) is hypervigilant even in totally safe circumstances. While such vigilance would be normal in a dangerous situation such as on a battlefield or in a dangerous urban area, in a classroom it can pull a child away from hearing what the teacher is trying to teach. While the teacher is going on about long division, the child is noticing the bug crawling across the ceiling, the janitor outside mowing the lawn, the kid across the room trying to discreetly pick his nose, or the interesting way his pencil can scratch the surface of his desk if he first chews away the eraser and uses the metal collar as a pen-point.
Impulsivity is the process of jumping into action before thinking through the consequences of a behavior. When it’s acted out verbally, it’s the old “mouth engaged but brain not yet in gear” problem: blurting out inappropriate things, interrupting others, or generally talking too much. When impulsivity moves into the arena of physical behaviors, it can be particularly destructive, ranging from leaping into fights or line-jumping to impulsively deciding to try a cigarette or leap into a risky situation.
Stimulation-seeking behaviors are ways a child (or adult) with ADHD gets the adrenaline on which they seem to live. While there’s often a huge overlap with impulsivity and distractibility, these take behavior to entirely higher level. Kids act out in class (sometimes called “attention seeking behavior” or “being bad”), push the envelope on the playground by swinging too high or skateboarding too fast, and, as adults, are drawn to high-risk professions such as police and emergency work, investigative journalism, politics, sales, and entrepreneurialism. At their best, these behaviors can lead to an interesting life; at their worst they can lead to unsafe sex, experimentation with drugs, and hanging out with the “wrong” crowd.
These three make ADD: add hyperactivity and you have ADHD.
While everybody has all of these behaviors in some measure as part of the spectrum of behaviors available to us, kids and adults with ADHD have all three in high measure, often well beyond the control of strict teachers or fretful parents. These behaviors are often observable as a particular type of temperament right from birth, and persist all the way through childhood, adolescence, adulthood, and even into old age. In order to be classified as ADHD all three behaviors must have such an intensity that they “impair” a child’s ability to function in the public schools or in other areas of life (although school is the primary one looked at).
The ADHD behaviors are also partially inherited. Studies of identical twins indicate that about half of the intensity of the ADHD behaviors is hard-wired from before birth: they’re genetically driven. The other half comes from the way kids grow up, but this definitely does not mean that ADHD has anything to do with “bad parenting.” It’s just that among identical twins, slightly more than half the time both twins will have ADHD if one does, whereas among fraternal twins (who each came from a separate egg and sperm) the odds both will have ADHD if one does are just over thirty percent.
Studies done with various types of brain scanners show that the brains of ADHD children and adults function differently from the brains of their non-ADHD peers, although this doesn’t necessarily mean ADHD is a disease or dysfunction. Left-handed people, after all, will show significantly different brain scans from “normal” right-handed people, and people who have devoted a significant part of their life to a particular skill (like playing a musical instrument or gymnastics, for example) will also show “non-normal” brain scans, as they have developed particular parts of the brain. Our brains, it turns out, are enormously “plastic” – capable of actual physical and functional modification as a result of learning and experience. In fact, your brain is now physically and functionally different than it was before you read this page, because your brain has just experienced words and concepts that it didn’t have in there before.
What ADHD isn’t
ADHD is not a failure of morality: ADHD people aren’t inherently “bad.” They’re not “brats.” Children and adults with ADHD aren’t “bad seed” or born cursed or with the “mark of Cain,” or any of the other many terrible labels which have been applied to them over the years by unthinking, misunderstanding people.
These behaviors are not the result of neglectful parenting or child abuse, although severe child abuse can produce some symptoms that are sometimes mistaken for ADHD.
People with ADHD are not specifically retarded or gifted: children of all intelligences can have ADHD. Sometimes children who are so slow they’re lost and confused, or so bright a normal classroom bores them, end up misbehaving in school and are thus mislabeled as having ADHD. But intelligence is not an indicator or correlated with ADHD, except in that kids with ADHD will often test out lower on IQ tests than their actual intelligence because most IQ tests measure test-taking ability along with the narrow range of skills we call “intelligence.” (There are, of course, other intelligences. But how often have you heard a teacher or psychiatrist describe a child or adult as “musically disordered,” “art dysfunctional,” or having a “creativity deficit”? Because these intelligences are not useful to the vast majority of jobs in our culture, we tend to ignore them.)
ADHD is not depression or mania. Back before physicians and psychotherapists became well informed about ADHD, it was quite common for people with ADHD to be diagnosed as having manic-depressive or bipolar disorder. But they’re very different things, which require totally different treatments. On the other hand, it’s also not uncommon to see mood swings and mild depression – and often high levels of enthusiasm when into something interesting – among ADHD children and adults. The enthusiasm is a function of the hyperfocusing capability we see in ADHD individuals: when they’re fully engaged in something (be it a video game, a skateboard, or a relationship) time seems to stand still and they can perform heroic feats of focus. (This gives the lie to the label attention deficit: the deficit is in having the ability to focus strong and sustained attention on things in which they have no interest.) The mood swings or mild depression are often secondary characteristics that are not the ADHD itself but are quite reasonably caused by children or adults not fitting in to a school system, job, or culture which doesn’t value ADHD behaviors or even punishes them. When people are in life situations that don’t work, it’s a perfectly normal reaction for them to feel down: if they didn’t, it would be a warning flag.
Stories about ADHD
Having shared the above information with Justin, Louise, and me, the psychologist then wandered into some unfamiliar territory. “There are many different theories about what causes ADHD,” he said, “including neurotransmitter imbalances, structural brain differences, and brain damage. Of course, an early version of this was called encephalitic brain damage or EBD back in the 1930’s when an encephalitis epidemic on the east coast caused a cluster of kids with attentional problems, and later that name was changed to minimal brain damage when kids without encephalitis histories were found to have problems paying attention in school, and then by the 1960s to minimal brain dysfunction because the term ‘brain damage’ seemed pretty severe. But in reality ADD has been with us probably forever. You can find stories in the Bible of ADHD-like behavior.”
He then proceeded to share his own favorite story of what ADHD was with us. It’s a story that I think should be banned from use by professionals in this field because it can be so destructive. He said, “It’s a little like diabetes. Diabetes is a fancy medical word we use to describe a disease that is actually an ‘insulin deficiency disease.’ The insulin producing cells of the pancreas die off from an autoimmune condition or infection, leaving the body without the ability to produce insulin, which is a hormone necessary for life. Without the insulin people will die, so we use daily injections to supplement their body with insulin we take from animals’ pancreases.
“Similarly, young man,” he continued, “your brain has been damaged. We don’t know how or where or when or why, but it’s not working right, and so we’re going to need to supplement your neurotransmitter levels with Ritalin.”
Right at that moment, as he was speaking, the story started to break down for me. The first breakdown came, of course, because the little scientist in me knew that there isn’t some organ in the body that squirts Ritalin into the bloodstream all day long. Whatever it may be, ADHD is not a Ritalin deficiency disease.
The larger breakdown came, however, at my concern about the impact the story would have on my son.
You see, there is one thing that study after study over the years have proven if a person has in large measure they’ll be more resilient, more capable of withstanding severe trauma, will heal faster from everything from infections to broken bones, and will even live longer if they have a fatal disease. On the other hand, studies and our own intuitive wisdom tell us all that without this one thing, people will die faster, heal slower, and be at greater risk of totally falling apart when life hits them with its inevitable problems. That one thing is hope.
And the ADHD-as-diabetes story is one without hope. Juvenile-onset diabetics face a profoundly difficult life, filled with danger of early death. Quite literally, every day is a life-and-death struggle. If they have hope, it’s hope that a pancreatic transplant or cell transplant cure may be discovered, but mostly the hope is simply that they’ll remember to give themselves the right dose of insulin at the right time and stave off gangrene, blindness, and aphasia.
But he didn’t stop there. When he asked my son what he wanted to be when he grew up, and Justin said, “A marine biologist,” he had a startling reply.
“You can forget about that,” he said, “because kids with ADHD don’t usually do well enough in school to make it to college. Are you any good with your hands?”
“Yeah,” Justin said, looking at his hands with a bewildered expression on his face.
“Well, then you could go into auto mechanics!” the man said with great enthusiasm. “If you do, however, remember to get into fixing foreign cars: they’re much more profitable than American cars. Every time I take my Mercedes into the dealer, they charge me two hundred dollars for just driving through the door...”
Now auto mechanics is a noble trade and I have great respect for its practitioners. If it has been Justin’s passion, I would have been encouraging him, too. But since he was young, he’s wanted to work with fish...and never had much interest in carburetors or axles. I tasted blood from biting my tongue (it didn’t seem useful to try to argue with a guy I’d just paid four hundred dollars to), and Justin’s eyes were filling with tears. Louise and I rescued him from that guy as fast as we could.
On the way home, he said, “What’s wrong with me?”
I had to honestly answer that while I’d thought of myself as somewhat of an expert on all this stuff, and had even published a paper on hyperactivity a decade earlier, I obviously didn’t know the answers. “But,” I promised him, “I intend to find out.”
The next six months were a whirlwind of research activity. I searched university FTP sites on the internet, bought every book I could find on ADD in the local bookstore, visited the Emory Medical School library to collect papers and articles on ADD, and called the psychologists, psychiatrists, and psychotherapists I’d worked with in New Hampshire. I was collecting stacks and piles of paper on the topic, which gradually spread from my office to the living room to the bedroom. (Louise says I don’t have a filing system: I have a piling system.) Everything I read had the same basic message: ADD is a pathology, a sickness, of unknown origin, which is best treated by stimulant medication. At that time, many people were still writing that it would go away after adolescence, although some researchers were discovering that it’s a lifelong condition and what goes away after adolescence is the need to function in a public school system which is intolerant of ADHD. Everybody agreed, though, that it was a disease, and nobody had any idea at all about why it was still in the human gene pool.
A new story
One night in the midst of this, about six months after my son’s diagnosis, I was sitting up in bed around two in the morning reading Scientific American magazine. The article was a thoroughly boring analysis of the genome of wheat and rice, and the article mentioned that one of the reasons why it’s so important to understand when wheat and rice appeared in their most modern forms (apparently around 10,000 years ago, as I recall, at the end of the last ice age) is because they were pivotal to what we call the Agricultural Revolution. This was a time when some of the tens of thousands of tribes of humans on this Earth shifted from hunting-gathering lifestyles to the use of agriculture to produce their food.
As I was drifting off to sleep (I read boring stuff at night to induce sleep: it’s cheaper than sleeping pills), I wondered what it would have been like to be alive during the time of my own ancestors from northern Europe ten thousand years ago, before agriculture. They were hunter/gatherers, and lived that way for tens of thousands of years before the appearance of agriculture. Thinking about this, it occurred to me that a hunter going through the forest in search of his family’s dinner would have to be extremely vigilant – noticing everything around him and in his environment – or else he may miss the rabbit which is going to be his dinner, or the lion or bear which wants to make him its dinner. He’d have to be scanning his entire environment, constantly, if he was to be both successful as a hunter and safe as a human being.
And like a flash, the thought came to me that this was a perfect definition of what we call distractibility when it presents as a behavior in public school.
But wait a minute, I thought – I learned that distractibility was a pathology, and the proof of that is that when distractible kids are put in an even more boring environment, their distractibility increases. But, I continued with the thought, what would a hunter have to do in the forest if he didn’t see anything to eat? He’d have to look harder, to scan more fully, to become even more vigilant.
Wow, I thought, that’s one of the three primary behaviors that make up ADHD. But what about the other two, impulsivity and stimulation seeking behavior?
If a hunter was chasing a rabbit through the forest and a deer ran by, the hunter wouldn’t have the time to pull out a pad and pen and sit down to do a thorough risk/benefits analysis. He couldn’t draw two columns, one labeled bunny and the other deer, and write under the bunny column, “less meat but easier to catch” and under the deer column “more meat but harder to catch.” Instead, he would have to make an instant decision. He’d have to be engaged in either ignoring or shifting to chasing the deer within microseconds. (And such decision-making ability would be even more important if something were chasing him!) This behavior engaged before careful thought occurs is the dictionary definition of impulsivity. It wouldn’t just be a useful behavior in a hunting world, it would be essential for survival.
Two out of three, I though. But what about that stimulation-seeking behavior? Again, consider those hunters who wake up in the morning and say, “What sounds like fun to me today is to go out there in the natural world where there are things I want to eat and things that want to eat me, and use my skills and knowledge to find the former and avoid the latter.” They would be the most likely to be successful hunters. On the other hand, the failure hunters would be the highly risk-averse ones, the people who say, “I think I’ll just stay here in my cave or tipi until all the lions or bears or snakes have gone away.” Such hunters would starve, because the predators never did go away: they’re still out there.
Could it be, I thought, that ADHD was adaptive? That it was a collection of neurologically mediated behaviors that would make a person successful in a primitive hunting environment, but are not useful in a modern classroom?
The answer would have to be found in the neurology of the farmers, the other end of the spectrum. In an agricultural world, distractibility would be devastating. If today was the perfect day to put in the crops (farmers and gardeners know how critical the timing of spring planting is) and the farmer were distracted by a butterfly that he went off chasing into the forest, or he procrastinated in planting the crops, people could die. Instead, a very focused mentality would be necessary – the ability to pay attention today to one and only one task: planting. Everything else would have to wait: multitasking is not an option.
Similarly, farmers couldn’t make snap decisions. While the food cycle for a hunter is 24 hours, it’s a full year for farmers. The farmers would need brains that were wired in such a way that they could see out into the future a full year and glimpse the consequences of their actions today. They’d have to be neurologically set up so that the idea of picking bugs off plants – bug after bug, plant after plant, hour after hour, day after day, week after week, month after month, year after year, decade after decade, generation after generation – was something they considered fun. (Today, of course, we call these people tax accountants.)
Eureka! I thought as I sat up in bed, wide-awake. This was the answer I’d been looking for.
The power of stories
At that time, I wasn’t trying to find the scientific explanation or answer to ADHD (although I was curious about that, too). Instead, I was looking for a new story to give to my son that could replace that hideous diabetes/insulin story the psychologist had dumped on him.
I discovered the power of stories more than a decade earlier, when I ran a residential treatment facility for emotionally disturbed children. I remember one Friday afternoon a social worker dropped by around four in the afternoon. She had a ten-year-old girl in the back seat.
“Her name is Shannon,” the social worker said, “and I don’t know her history. Her social worker is on vacation this week, and I just picked her up from the police station, and because of confidentiality laws the only thing my office could tell me was that she can’t go home to her parents. So if you don’t have a bed for the weekend as an emergency placement, I’m going to drop her off at the state mental hospital for the weekend, as I’m on my way home.”
By coincidence, we had an empty bed that day as a child had been discharged back to her family earlier in the week. So I took in Shannon for the weekend, with the agreement that on Monday we’d get together with her regular social worker, find out what the situation was, and decide if she was an appropriate placement for our facility or if we should refer her out to a foster home or another institution. The social worker left, and I assigned Shannon to Karen’s house, as that’s where we had the empty bed.
Karen was one of our best-ever childcare workers. She was smart, loving, insightful, and emotionally strong. That Friday night she took Shannon up to the empty second-floor bedroom and said, “Here’s your bedroom, there’s your bed, and there’s a nightgown. You get read for bed and I’ll be back in ten minutes.” Karen went downstairs and had a cup of herbal tea.
Ten minutes later, Karen returned to Shannon’s room to find Shannon had changed into her nightshirt, and was laying on top of her bed, facedown. Karen sat on the bed next to her, and reached over to give her a gentle backrub. She was going to say, “I’m really glad you’re here, and we’re going to have a wonderful time this weekend. You’ll have fun, learn a lot, and it’ll be a great experience for us both.”
But Karen never had a chance to say those words, because just as her hand lightly touched Shannon’s shoulder, Shannon exploded off the bed at her, screaming and clawing and biting, shouting that she was going to kill Karen and slashing for Karen’s face with her nails.
Karen grabbed Shannon’s wrists and flipped her over on the bed, face down, and essentially fell on top of her, both of them facedown, holding her so she couldn’t hurt either herself or Karen, as Shannon continued to sputter and shriek and scream. (Her yells were so loud that Louise and I came over to find out what was going on.) Karen was talking Shannon down, saying, “It’s ok, you’re safe here, everything is going to be fine.” And after about four or five minutes (which is an incredibly long time for such behavior to persist), Shannon eventually depressurized and lay quietly on the bed, panting to catch her breath.
Thinking it was now a safe time to sit up, Karen let go of Shannon’s wrists and hoisted herself erect. She looked down at the little girl and saw that during the struggle Shannon’s nightshirt had worked its way up to the middle of her back. To her horror, Karen saw that Shannon’s back was covered with cigarette burns, old and recent.
If you were to ask Shannon at that moment in time who she was, she would have told you her truth. She would have said that she was the little girl who was so bad that the only way you could control her behavior was to put cigarettes out on her. (And, truth be told, she was the master of angering adults.) Shannon absolutely believed this, and had years of experience to prove it.
You see, what happens is that as we go through life – particularly childhood – we collect stories about who we are. They come from our parents, siblings, peers, and teachers. We find them in our culture and our media. The stories fall into two basic categories: I am/I can and I’m not/I can’t.
The I am/I can stories form the foundation of our lives. They’re the floor we stand on as we move out into the world. They take many forms: I’m the fat one; I’m the skinny one; I’m the smart one; I’m the dumb one; I’m the cute one; I’m the ugly one; I’m the good one; I’m the bad one, and so on. Most are actually far more elaborate, but all start with these simple building blocks. They are the stories of who we are, and they define our posture and position, our power and our willingness to undertake things.
The ceiling and walls of our lives are the I’m not/I can’t stories. They tell us who we’re not, and what we’re not capable of. I could never go bungee jumping; I can’t speak in public; I’ll never be able to get a management job; I’m no good at math, and so on.
These stories stick to us as we grow through childhood the way lint sticks to a cheap suit or burrs collect in the fur of dogs in autumn. We test them against the world a few times, and if the response we get validates them, we decide they’re real and they become part of the floor, walls, and ceiling of our lives. They form the box in which we live, and very, very few people will ever go outside that box or step off that floor. In a very real way, you could say that the stories we tell ourselves about who we are and what we can and can’t do are our fate, our destiny. They determine our future.
Changing these stories is incredibly difficult, once they are accepted. In psychoanalysis, if even a small shift can be accomplished, it can be life-transforming. Brainwashing and boot camp are other examples of times when people’s stories are intentionally shifted, but, again, these are difficult processes and, in the case of boot camp, only a very small part of the overall structure of a person’s stories is touched. By and large, most people will never change the core stories they develop during their childhood. (Which may account for our fascination with novels and movies in which the lead character experiences a major personality transformation, because this is such a rare event.)
So, understanding – as I did – the power of the stories we tell ourselves, I came to an absolute and compete conclusion: I did not want my son to be walking around for the rest of his life saying to others and (most important) to himself, “I’m the one with a deficit, I have a brain disorder.”
Even if it’s true.
It may, of course, be true (although the jury is very much out as you’ll discover as you read on here at hunterinafarmersworld.com) that ADHD is a brain disorder. But even if that is the case, I thought it was a disempowering story. It wasn’t useful. It didn’t add to my son’s hope, or enhance his resilience, his ability to handle the adversities that life will inevitably throw at him.
So, what I was looking for was a different story. I wasn’t a parent in denial: I wanted a story which would acknowledge all the realities of ADHD. I wanted to be right up front about the fact that the way my son learned and the way the schools teach were in conflict, that he would probably face a real challenge in public schools. That he may have to learn new study skills, and would probably have to work harder than his equal-intelligence peers to achieve the same grades. That he may have to take medication or even go through some sort of psychotherapy to deal with the wounds that had been inflicted on him by a school system that was hostile to his particular neurology. I wanted to acknowledge all those realities.
But I also wanted him to have hope, which that tired, sick diabetes/insulin story stole from him.
So when this thought of hunters and farmers came to me, I sat him down and said, “We’ll keep that ADD label, because in the current screwed up school system it may get you a better teacher. But don’t take it too seriously. I don’t think you have a deficit or a disorder: I think you’re my son. And I’m the son, on my mother’s side, of the misfits and malcontents of British society who came to this country in the 1600s and fought a war of independence against the conformist British. And I’m the son of a father whose parents came to America in 1917 from Norway, who were the descendents of the Vikings – those people who terrified most of western Europe for two thousand years. We’re the descendents of the warriors, buccaneers, pirates, explorers, and...well...hunters of Europe.
“But in the past thousand years, the farmers have taken over. They’ve taken over the schools so completely that they even let out during the summer so the kids can help bring in the crops! So, you have two choices. One, you can learn to fake it during the school hours and behave like a farmer. And we can talk about how you can learn the skill-set to do that. Or, two, you can take these farmer pills (Ritalin), which will make your brain work just like a farmer’s brain for about four hours. Or you can do both until you have the farmer behaviors down pat.”
In this context, my son was able to accept his ADHD without putting himself into the category of damaged goods (he has a T-shirt that says: I’m not disordered – you just can’t keep up!), yet was still willing to consider the entire range of “normal interventions” for what we call ADHD.
This was my first learning about ADHD. As time went on, I dug deeper and deeper into the literature, talked with more and more of the researchers, and learned some truly interesting and often startling things in the process. We’ll explore them in future chapters.
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 PET, SPECT, and EEG, primarily
 reconstructing the conversation as best I can from memory
 Dr. Richard Silberstein of Swinburne University in Melborne, Australia, wrote a marvelous and very scientific paper on now hope measurably effects the physical, chemical, and neurological functioning of the brain. The Neurobiology of Hope.