What Maslow Overlooked: The Need to Feel Alive
Realizing that ADHD children and adults are being driven not by an urge to be bad, but rather by an inborn and unmet basic human need, we can view their plight with more compassion and understanding.
“People say that what we’re all seeking is a meaning for life. I don’t think that’s what we’re really seeking. I think that what we’re seeking is an experience of being alive, so that our life experiences on the purely physical plane will have resonances within our own innermost being and reality, so that we actually feel the rapture of being alive. ”
—Joseph Campbell, The Power of Myth (1988)
When Abraham Maslow wrote Motivation and Personality back in 1954, he didn’t have the advantage we do now of a reasonably thorough knowledge of neurochemistry. He observed people and the way they interacted with the world, and developed his theory of the “hierarchy of human needs,” which ranged from the need for safety to the need for social interaction to the need for what some may call religious experience.
But Maslow had his own particular neurochemistry, which colored his observations and caused him to overlook a critical point. This overlooked basic human need may, in fact, be so critical to an understanding of human nature that understanding it gives us a revelatory flash of insight into the nature of personality disorders and specifically attention deficit hyperactive disorder (ADHD). This is what I call “the need to feel aliveness,” and it also explains why some people have multiple jobs, mates, and life¬styles, whereas others settle into one fixed routine and stay with it their entire lives, apparently quite happy in their stasis.
To understand how Maslow could have overlooked a fundamental human need which drives the behaviors of as much as 30% of our population, it’s important to first understand how a particular part of our brain is wired. This part of the brain, and the way it works, can cause this need to come into being, or, to remain unexpressed.
The part of the brain which most likely drives this process is called the thalamus.
Our sensory volume control
All of our senses except smell flow into a small structure near the base of the brain called the thalamus. When we hear, see, feel, or taste something, that information from the sensory organs and nerves is first passed along to the thalamus, before being relayed to the rest of the brain.
What our eyes see, for example, moves along as electrochemical impulses through the optic nerves (through the optic chiasma) to a part of the thalamus dedicated to vision. From there, the signals project to the part of our brain that actually sees, the primary visual cortex located in the occipital lobe of the cerebral cortex. The same process occurs with sound, smell, and taste.
The thalamus acts in much the same way as a faucet does on a sink. Sensory inputs pass through it on the way to their final destination (much like water must pass through a faucet to reach the sink). The faucet of the thalamus controls how much of that information reaches its ultimate destination—and how quickly and at what level of strength.
Another model, suggested by Dr. Dale Hammerschmidt of the University of Minnesota’s Medical School, is of the thalamus as a graphic equalizer on a stereo system. This is probably a more accurate way of looking at it, as the thalamus doesn’t apply the same amplification or attenuation to each sense. Some people are more sensitive to sight, others to hearing, others to touch, and some to taste, or any combination of these four. These anomalies are sometimes the result of thalamic variations. However, I’ll use the faucet metaphor here both because of its simplicity and because not everyone is familiar with a graphic equalizer.
Another important brain structure connected with the thalamus is the reticular formation (often called the Reticular Activating System or RAS).
The RAS is a large group of nerve cells which originate deep within the brain. Long nerve cells that look like fibers grow up from this area through the thalamus, and then extend on out into and throughout various parts of the cortex (our thinking brain). It’s as if the thalamus had a little curled-up porcupine underneath it, with disproportionately long quills which stick up into virtually every important part of the conscious brain.
Largely on orders from the thalamus, the RAS tells the conscious brain how alert it should be. The RAS is responsible for the startle reflex, and is one of the primary control systems for our general level of arousal or awakeness.
The thalamus and the RAS are the ever-vigilant doorkeepers of our senses, and, as part of our most ancient brain structures, they have as a primary responsibility to provide information to the brain for that most ancient of instincts—the fight-or-flight response. They are responsible for our safety and survival (at the most primal level of Maslow’s hierarchy).
Let us say that the thalamus gets an unusual input from the eyes or ears—say a loud noise or the sight of something flying at us. Instead of just normally passing it along to the cortex so we could think about it, the thalamus will do two things:
First, it turns up the volume level for that particular sight or sound, so our conscious brain will notice it more vividly. (People who’ve been in car accidents often relate how clearly they remember seeing the oncoming car, for example. This is the result, in part, of the thalamus having opened up the faucet, thus producing a more memorable impression on the brain.)
Second, the thalamus will activate the RAS, saying, “Hey, wake up the rest of the brain! Something important and maybe dangerous is happening out there!” The very long and super-efficient nerves of the RAS transmit a whoops!/startle impulse to the brain, that adds a huge dose of impact to our sight, sound, feeling, or taste.
The RAS and thalamus are so powerfully involved in maintaining and modulating our level of awareness or awakeness, that if either are accidentally damaged during surgery or in an accident the person will slip into a permanent coma. Similarly, it is believed that when someone sustains a concussion which knocks them unconscious, it’s because the RAS has been jarred hard enough to shut itself down as a defense strategy.
So, in combination, our thalamus and our RAS control how much of the world around us we sense—how fast and with what volume the input flows through the faucet of the thalamus, and how awake or aware we are as we process that input.
People with a wide-open thalamic faucet are awash in sensory input.
Closed and Open Faucets
One of the more interesting recent medical discoveries is the fact that each one of us has a slightly different “normal” setting for how open or closed the faucet of our thalamus is, and also how hair-triggered our RAS may be at activating the rest of the brain.
People with a wide-open thalamic faucet experience sight, sound, touch, and taste as being strong and vivid: they’re flooded with sensory input. The result is that they often want to back away from the world. Their sensory experience is sometimes painfully bright. Boisterous conversation or loud music overloads their brains, and they’re uncomfortable with strong touch or other intense physical sensation.
These people are sometimes referred to as introverts, although in the context of Carl Jung’s original meaning for the term this is a misnomer. Nonetheless, people with a very active thalamus and RAS tend to be quiet, withdrawn, and to dislike wild disruptions in their lives. Their primary life strategy is often avoidance of excess sensation, pain, emotion, or disruption.
So much input is flowing through the thalamus and RAS into the cortex that they necessarily step back from life and look for a little peace and quiet.
On the other end of the spectrum are those people whose thalamus and RAS are not as open: less sensory information flows through, or flows through with a lower intensity. People with a more-closed thalamic faucet experience the world as “too quiet.”
Since the faucet is closed a bit tighter, less continuous sensory stimulation comes through, and it takes a much more dramatic event to punch through and activate their reticular startle response.
These people see, hear, taste, and feel (in terms of sensation, not emotion) less vividly. Rather than trying to push them¬selves away from the world, they throw themselves into it, often with an intensity that is bewildering to the open-faucet-thalamus folks.
Since it takes a stronger sensory input to make it through the faucet of their thalamus and RAS and into their thinking/experiencing brain (the cortex), these people are not overwhelmed by bright lights, strong colors, loud sounds, intense physical sensations, or strong tastes. If anything, they enjoy these things, be¬cause such sensations bring them, if only for a few moments, into a more close and intimate contact with a world they may normally feel is a bit distant.
We’ve all known people who fit into the two extreme ends of this spectrum: they’re stereotypes or cliches in our society and in popular literature.
Closed-faucet folks who crave stimulation live for the party, love to perform in front of people, are enthusiastic about skydiving or roller coasters, and consume hot peppers with an enthusiasm that baffles their friends.
Open-faucet folks, inundated by sensory input, just want to be left alone, don’t generally speak up, appreciate subtle things such as fine art and classical music, and often are quick to dismiss the closed-faucet folks as boors or egomaniacs.
And then, of course, there are those people who fall in the middle between these two extremes. The world is vivid to them, but not painful. They have enough sensory input to satisfy them, so they don’t go out of their way to create more for themselves, yet they’re not so overpowered by it that they feel the need to with¬draw. These people are the ones who some would consider “normal,” and Woody Guthrie loved to write and sing songs about them , e.g., “Little Boxes.”
But what, you may ask, does this have to do with basic human needs and things like ADHD?
A Human Basic Need: To Experience Our Own “Aliveness”
Psychologist Abraham Maslow gave us a remarkable look into human behavior when he outlined his hierarchy of needs. Maslow pointed out that, “The human being is a wanting animal and rarely reaches a state of complete satisfaction except for a short time.”
Similarly, one of the basic tenants of Buddhist thought is that humans are always wanting something. Buddha’s four noble truths are: (1) All life is suffering. (2) The cause of suffering is desire. (3) Give up desire and you end suffering. (4) The eight¬fold path to end desire (right thought, action, livelihood, remembrance, meditation, belief, speech, and exertion).
This is such a basic and universal tenant of human nature that we find it in virtually all philosophies and religions. Jesus said, “Lay not up your treasures where moth and rust doth corrupt.” Rabbi Isaac Luria, the Ari, also known as the Lion of Safed and one of the most famous of the 16th century scholars and mystics of Kabbalah, wrote in what was later translated as Ten Luminous Emanations about the importance of separating self from the desire for experience. In Hinduism, part of the Bodhisattva vow is to give up even the desire to give up desire. And, of course, Freud, Adler, Skinner, and other psychologists have pointed out that many of those behaviors we define as neurotic are really misdi¬rected attempts to satisfy basic needs, or are the result of unful¬filled basic needs.
Maslow wrote that our most basic need is for biological stasis. We need water, food, appropriate nutrition, to excrete, and to maintain our body at a constant temperature.
The second level he identified as the need for safety.
Once these basic physical needs are met, then we go off in search of our third need, which he identified as the need for love and belonging. When that’s met, we’ll start seeking self-esteem and status. And, finally, when all these physical and emotional needs are satisfied, a person will turn to what some might call spiritual needs, and which Maslow called the need for self-actualization.
Maslow’s insight into this hierarchy or pyramid of needs had a revolutionary impact on the field of psychology, creating a whole new school of psychological thought called Humanistic Psychology, and was profoundly insightful. He shows us why a person who is starving will not care much about his social status. For example, in 1980 in northern Uganda I went into a famine area to help set up a feeding center and hospital for starving refugees. Not only did they not worry about their appearance, many didn’t even care if they were wearing clothes.
Maslow points out some misconceptions many people have: for example, what we describe in western society as hunger, he calls appetite. Few of us have ever experienced life-threatening hunger, which is at the foundation of the pyramid of needs, or even when we say we are hungry, most of the time we simply crave a specific taste or flavor, or want that pleasant feeling of fullness in our stomach. This isn’t a stasis or survival need, but more likely a self-esteem or some other higher need.
Extending this concept, I believe that an understanding of the thalamus and RAS, and the study of ADHD, have revealed to us a basic human need that Maslow didn’t include in his hierarchy. I define this as “The need to experience aliveness: the need to feel that one is alive.”
Cogito, ergo sum, the philosopher Rene Descartes wrote in 1637, which means I think, therefore I am. Yet merely thinking is not enough to create, in many people, the reality—the down-in-the-gut knowledge—that therefore I am.
To validate therefore I am, we must experience the fact of our aliveness. Ugo Betti wrote: “At any given moment I open my eyes and exist. And before that, during all eternity, what was there? Nothing.”
We see that in different people, different thresholds of sensation are necessary in order to experience gratification of this basic human need to feel alive.
Nobel-prize-winning poet, playwright, author and philosopher Rabindranath Tagore, for example, had a life devoted to quiet meditation and contemplation. He enjoyed sitting quietly and pondering the nature of things, living within his mind (so to speak), presumably because his need for sensory input was ade¬quately satisfied. The faucet of his thalamus and RAS was probably wide open, and life came in at him full-force. The writings he left us say things such as, “That I exist is a perpetual surprise which is life.” Similar descriptions of the naturalness of aliveness, the fulfillment of that “need to experience aliveness” simply from being alive, can be found in the writings of many others, from Thomas Merton to George Santayana.
These people had their “need to feel alive” satisfied from birth. Their thalamus and RAS were open wide enough to experience the world constantly, in full Technicolor. Like a person after a perpetual Thanksgiving dinner they felt full all their lives.
Those with a thalamic faucet that’s more closed, however, need to periodically leap up through the baseline set by their thalamus to gasp in a full breath of aliveness. Their lives are characterized by a constant search for stimulation, and many are tortured by this basic need to feel alive on a daily basis.
The philosopher Pascal wrote in 1670, “There is a pleasure in being in a ship beaten about by a storm, when we are sure that it will not founder.” Would Tagore have said the same? Probably not. Pascal would have probably enjoyed The Scream Machine roller coaster at the famous Six Flags Over Georgia amusement park; Tagore would have probably dismissed it as crude and overly stimulating.
So we have here now a final “basic human need,” one which Freud first came close to nailing down in 1933 when he wrote about the Id: “We can come nearer to the Id with images, and call it a chaos, a cauldron of seething excitement.... These instincts fill it with energy, but it has no organization and no unified will, only an impulsion to obtain satisfaction for the instinctual needs, in accordance with the pleasure principle.”
This is not to say that the basic human need to experience “aliveness” is the same as what Freud called the Id, but I do believe that Freud was close to touching this need when he embarked on an exploration of those driving and motivating forces which lie below our normal levels of waking consciousness. After all, consider how few people are sufficiently self- aware to say, for example, “I like to drive fast because it makes me feel more alive.”
Yet how else to explain this sort of behavior, unless we leap to the conclusion (as Freud and others sometimes have) that such behavior must demonstrate an unconscious death wish? The idea of an unconscious death wish is interesting and, no doubt, occasionally true, but it doesn’t explain the liking of spicy foods, loud music, vivid colors, wild sex, and other types of sensation-seeking behavior that are often associated with the types of people who also drive like maniacs. They can’t all be trying to kill themselves!
So if these folks aren’t trying to kill themselves with all this sensation-seeking, what is their goal?
Perhaps it’s a Life Wish: To wake up, even if just for an instant a day, and viscerally know that they are alive.
Characterizing this previously-undefined human need as the basis of these behaviors then gives us a whole new key to under¬stand both healthy high-stimulation activities as well as destructive and self-destructive stimulation-seeking behaviors. In both cases, the person seeks the experience of aliveness. In the former, they’ve found appropriate ways to get it (skydiving, public speaking, sales, politics, substitute teaching, being an emergency room physician). In the latter case they’ve stumbled into-often by life circumstances which shut out the appropriate routes—destructive ways to experience stimulation (mugging people, taking drugs, having frequent sex with a wide variety of people, starting fights, gambling).
And how does this help us better understand ADHD and other variations from the norm?
ADHD and Trout
Anybody who’s ever gone fly-fishing is familiar with the behavior of those fish who eat insects off the surface of the water. The pond or stream is perfectly still, then the surface is disturbed as a small bug touches the water, trapped because its wings become wet. A small ripple emanates from the insect, as it strug¬gles to use surface tension as a lever to free and dry a wing. Suddenly the water’s surface is shattered as a fish comes surging up from below, snaps the bug and a big gulp of air into its open mouth, and then crashes back through the surface to vanish into the water’s depths.
Similarly, people with ADHD often appear hyperactive because they’re periodically leaping up through the surface of stimulus-a surface defined by the set-point of their thalamus and RAS-to try to grab a little bit of aliveness.
For example, little Howie is sitting in class while the teacher is droning on about long division, a subject which Howie either has already mastered or doesn’t care about. Howie’s thalamus and RAS aren’t letting much information in, and the world is starting to seem rather gray and distant. The thinking cortex, the therefore, I am part of his brain, is gasping for air and wants to leap at that bug: “Give me sensation,” it’s saying, “so I’ll know that I’m still alive.”
The urge is overwhelming: a basic human need is unfulfilled. Something has to happen. The brain is screaming: “Break through the surface!”
So Howie leans forward and pulls Sally’s pony tail, or lets out a loud burp, or flips a spitball at Billy. Bang! The classroom erupts and now the world is back in vivid color.
This simple action has penetrated the thin membranous surface of sensation that, like the pond’s surface, the thalamus had inserted between Howie’s mind and his experience of the world.
As an adult, Howie may tell an off-color joke, or cut someone off in traffic, or start his own business—anything to propel the brain up through the surface to gasp that breath (or snatch that bug) of aliveness.
If we look at the three basic behaviors associated with ADD, for example, we can reframe each of them in this context. They are: distractability, impulsivity, and sensation-seeking or risk-taking. ADD-H (hyperactive) adds the fourth behavior of hyperactivity, illustrated by little Howie at school.
Howie’s Distractability
The scanning behavior of distractability, viewed in this light, is the brain’s way of opening itself up to the experience of aliveness.
The boring teacher is droning on and on, and little Howie has already become distractible, looking around to see that Sally is very concerned with how neatly her pony tail is brushed, that Billy is carefully listening to the teacher, and that no one else is paying attention to him.
If he’s learned some physical self-control and has an active imagination, Howie may drift off into daydreaming instead of acting out, creating a vivid internal world that stimulates him. The Calvin and Hobbes cartoons virtually define this behavior. We see Calvin’s internal world for several panels, then have that world shattered as Calvin is brought back to reality by Miss Wormwood standing over him with a ruler asking him to answer the question. Similarly, psychiatrist John Ratey of the Harvard Medical School points out that girls more often fit into this category of “internal distractability” than do boys, both because of social conditioning and because of actual differences in male and female brains.
But whether Howie drifts into daydreaming, or moves into action, he starts out with distractability: his brain is seeking out new sources of incoming sensory information in order to wake it back up.
Impulsivity
Since we’re dealing here with a basic human need, all the scholarly and erudite attempts to explain ADD as having to do with defects in cognitive processes, disinhibition, or the frontal lobes (among others) really become secondary, if not outright irrelevant.
A truly hungry person will grab for food, often regardless of the consequences, as I learned in 1980. When my companion and I opened the trunk of the car we’d used to bring supplies from Kenya into the old Namalu Prison Farm (then turned into a refugee center) I was nearly trampled in the stampede of previously-docile teenagers and old women. People barely able to move because of disease or malnutrition were suddenly screaming, kicking, biting, and climbing over each other.
Just as the unmet basic human need for biological stasis (food, in this example) will drive people to otherwise unthinkable behaviors, so too will the basic human need to experience aliveness when it’s not met.
The brain is yelling, “Now, now, I need it now to be sure I’m still alive,” and it’s small wonder that Howie doesn’t take the time to consider the long-term consequences of cutting a loud fart. Or that Johnny and Sue don’t stop their progressively intense kissing to drive down to the drugstore for a condom. Or that Ralph tells his boss what he really thinks of him. Or that Bill leans over and tells Ruth what he heard about Ruth’s husband and that woman down in accounting.
Get a reaction. Get a response. Shake up the world. Make a decision and act—NOW. Wake up!
Restlessness or Risk-Taking
While most authorities cite the third primary symptom of ADHD as restlessness, many are now including risk-taking, or “the restive search for high stimulation.”
In this context, however, the conventional symptom of restlessness is actually just stimulation-seeking—and risk-taking also fills precisely the same need. In fact if you combine stimulation-seeking with impulsivity, what you get is a virtually perfect definition of risk-taking.
The equation here is simple: the more risk, the more adrenaline. And, as you may have guessed, adrenaline and its close relatives are the neurotransmitters to which the thalamus and RAS are most sensitive.
Some of us look at those people who are perpetual risk-takers and shake our heads in amazement. How could Bill Clinton have put up with all that abuse in the primaries and during the election campaign, particularly after being accused of marital infidelity and drug-use which had so recently sunk the presidential aspiration of Gary Hart and the Supreme Court aspiration of Judge Ginsberg? How could Lewis and Clark have persisted in their long voyage to map the interior of this wild nation despite hostile natives, disease, wild animals, and the combined threats of winter and starvation? How could the early settlers of America been willing to take the boat ride across the Atlantic in the 16th and 17th centuries when, on average, ten percent of the people who left Europe died during the trip here? How could a nurse or physician continue to work in an emergency room when every day, every hour, it’s one crisis after another? Or a police officer risk his life on the streets? Or a combat pilot engage in dangerous missions? How could someone engage in an extramarital affair, or in unprotected sex? How can anyone eat that lethally hot chili?
The answer, of course, is that people do these things because it satisfies a basic need in them. The experience of taking chances jolts them with sensation, and thus wakes up in them that feeling of aliveness—a need more basic and visceral than virtually any other except biological stasis. As author Andre Gide wrote in his Journals in 1924, “It is only in adventure that some people succeed in knowing themselves, in finding themselves.”
This also explains why a compulsive gambler, a sexually promiscuous person, or a compulsive criminal will often continue to take those same risks, even when they experience the negative consequences of them. The entrepreneur and the break-in artist are running off the same brain biochemistry.
“Everything is sweetened by risk,” said Alexander Smith (1830-1867), the famous 19th century author of Dreamthorp (1883) and other works. And John F. Kennedy, who took the nuclear-annihilation risk of staring down Khrushchev during the Cuban Missile Crisis, and the risk of sleeping with a variety of women during his presidency, said in a 1961 speech, “Any danger spot is tenable if men—brave men—will make it so.”
The “Paradoxical Effect” Explained
It’s been known for years that if you give stimulant drugs to hyperactive kids, they settle down. But no textbook on pharmacology or psychiatry can tell you why. Therefore, this oddity has been referred to in the literature as the “paradoxical effect.” But, if this thalamic/RAS model is correct, the hyperactive kids are the ones whose brains are the most starved for stimulation. Their thalamus and RAS are closed down more than the average person, thus letting less stimulus into their brains. Their brains are begging to be awakened, to be stimulated, and so they incite stimulation by jumping out of the chair or speaking out of turn. They have a basic human need which is not being met by the boring classrooms or comfortable life of modern society.
Stimulant drugs, from Ritalin to amphetamine to caffeine to cocaine, open the faucet of the thalamus. They make the RAS more active, and more aggressive in sending wake-up signals to the cortex. In other words, to use the fish jumping out the water example—they lift the person’s consciousness above the water level, into a place where it’s constantly bright and interesting. The person then no longer experiences the need to leap up and crash through the surface.
Now that his basic human need of aliveness is satisfied, little Howie doesn’t need to scan his environment for interesting things. He’s no longer distractible, because the level of light, sound, touch, and taste around him have all jumped up a notch or two. This increasing flow of stimulus satisfies his need to experience aliveness, and, now that this basic need is met, he can sit quietly in the chair and attend to the teacher’s instructions.
Similarly, when medicated with stimulants, he’s not feeling that underlying drivenness that comes from having a basic human need unfulfilled. Because he’s not feeling driven to fill a need any longer, it’s easy for him now to toss thoughts over to the frontal lobes for deliberate and careful consideration. He need no longer be impulsive. Thinking things through is not boring any more, simply because Howie himself—his baseline, his therefore, I am is no longer experiencing an unfilled need. In other words, Howie is no longer bored, so things around him cease to be boring.
Howie is now less likely to engage in risk-taking such as grabbing Sally’s pony tail, because he now has enough sensation in his world. He’ll soon discover, when medicated, if he does things to increase his sensation level, he’ll experience discomfort, perhaps even panic. Those things that used to make him feel good, that once fulfilled his need for aliveness, now overwhelm him. And so he stops the risk-taking and settles down into becoming a “normal” citizen of his school or family or world.
This view of ADD also explains behavior like procrastination and overcommitment: both are simply ways of creating a crisis, thus bringing up the adrenaline levels so the sense of aliveness is more acute.
ADD Manifestations
In placing the “need to experience aliveness” on Maslow’s scale of human needs, we see a variety of ways in which people can fulfill this need. Maslow points out that people are rarely stuck in just one of the levels of the hierarchy, but operate instead at different levels simultaneously. We tend to have one primary place where we’re dealing with life’s issues at any given moment in time. For a closed-faucet person, that place will always be colored by a need to feel aliveness, because this need is so primal.
It may be that we’re mostly struggling with the need for a place to live, or perhaps that the need to be loved is primary in our lives. Or even the need for self-actualization drives us as Maslow said it did him.
When we know whether a person is closed-or open-faucet, we can predict how they’ll express or act out their other needs. Closed-faucet people struggling with the need for love will be distracted by the opposite sex, make impulsive decisions about relationships, and take risky chances in those relationships. Those people struggling with the need for self-actualization, on the other hand, will leap from group to group, guru to guru, in the quest for new experience and insight. Of course, you could apply this logic to any level of need and behavior.
Open-faucet people, on the other hand, will be more cautious in their seeking and less likely to connect with high-stim situations, people, or relationships.
When I shared this concept of a new basic human need that Maslow may have overlooked with psychotherapist George Lynn, he observed:
“Your emphasis on this additional human need to feel alive in Maslow’s Hierarchy makes a lot of sense. This explains the rage that my ADHD clients’ parents tell me their kids experience in school. Rage may be a response to having a basic need suffocated or starved.” (Italics added.)
This is so common-sensible as to be intuitive, particularly for those people with a closed-faucet thalamus/RAS who have experienced this in their own lives. These kids and adults are different from the norm, and their core self will instinctively resist being squashed into society’s proverbial round hole.
Is it Learned or Built-in?
This discussion of distractibility, impulsivity, and risk-taking in the context of the set-point of the thalamus and RAS may cause one to conclude that these behaviors are hard-wired into our brains, and therefore unchangeable with anything short of a drug or surgery which would reset the thalamus.
A careful look, though, will suggest otherwise. The thalamic set-point creates conditions in which particular behaviors are most easily learned, but is not in and of itself responsible for those behaviors.
For example, if a baby with a closed-faucet thalamus is feeling the need for more input, he or she may start to look around the room in search of stimulus. This distractible behavior is rewarded when the baby sees the mobile over her bed, and the first step toward learning how to behave distractedly is formed in the young brain.
Similarly, if the baby is feeling the need for stimulation and impulsively reaches out and grabs a vase, shattering it on the floor, the reaction from mom (assuming it’s not too negative) and the sensation of the sound and appearance of the shattering vase all teach her that impulsive grabbing produces sensation, which equals reward. And the risk-taking of crawling into new areas, poking the cat, pulling on the tablecloth, etc., all produce more and more interesting stimuli, which reaffirm to the child that he is alive—thus fulfilling that basic need.
On the other hand, a child born with a high thalamic set-point, a wide-open faucet, may be content to simply lay in his crib and play with his fingers. That soft sensation is enough to fill his cortex with input, to affirm his aliveness, and he doesn’t then learn to behave in ways that we’d describe as distractible, impulsive, or risk-taking. If anything he’d learn the opposite lesson: the crash of the vase that would delight the low-stim baby by arousing his brain would represent an overwhelming and unpleasant amount of input for the baby with a high-stim setting on his thalamus and RAS.
We see that the behaviors most often associated with ADHD are actually learned ways of fulfilling a basic need, but they’re more-or less-easily learned based on inherited brain chemistry and structure. The needs for these brain-structure differences, these different thalamic set-points, could reasonably be traced back to types of neurochemistry most useful in hunting or farming societies.
That this is both a function of the neurological set-point and of learned ways to satisfy the basic human need it mediates is clearly demonstrated by a twin study done in 1989 by Goodman and Stevenson. This study looked for symptoms of hyperactivity among 127 pairs of identical twins, and 111 pairs of fraternal twins.
If what we call hyperactivity were purely biological with no learned component, one would expect to find a 100% concordance among the identical twins. If it was merely learned, it would probably be in the range found among the general population with a slight boost from the shared environment.
What they found was that among fraternal twins where one of the twins had been diagnosed as being hyperactive, the incidence of both twins being hyperactive was 33%. Among the identical twins, however, it jumped up to 51%. So clearly, even something as apparently baseline as hyperactivity contains both a nature and a nurture aspect.
Since these behaviors contain a learned component, it’s reasonable to theorize that it should be possible to learn new, different, and more appropriate ways to fulfill needs, as did Abraham Maslow himself.
Why Maslow Overlooked this Need
In the last interview done with Abraham Maslow before he died in 1968, Psychology Today writer Mary Harrington Hall asked him about his own life and personality. He proudly spoke of how his father had hitchhiked all the way across Europe from Russia to arrive in America at the age of 15. And how he, himself, had dropped out of law school in his first year because, rather than studying one single topic, he wanted to study “everything.”
In a reprint of that interview in 1992, Psychology Today author Edward Hoffman noted that Maslow was “temperamentally restless and ceaselessly active,” and that he found convalescence at home from a major heart attack to be “almost painfully unbearable.”
When asked by Hall, “How would you describe yourself? Who are you?” Maslow responded: “I’m someone who likes plowing new ground, then walking away from it. I get bored easily. For me, the big thrill comes with the discovering.”
It would seem, then, that perhaps Abraham Maslow himself was a relatively closed-faucet person. He eagerly described in the interview moments from his life when he reached out for sensation, acted impulsively, and took risks. Some might say that his putting forth audacious new theories of human nature was, in itself, a highly risky activity.
Yet we’re often blindest to our own nature. Without the context that the then-emerging field of neuropsychiatry could provide for his hierarchy of human needs, it would be easy for Maslow to assume that his own drivenness was merely a quest for satisfaction of the basic needs, or the cognitive needs (esthetic needs, and the desire to know and to understand) of self-actualization.
He acknowledged his tendency to overlook fundamental is¬sues while buried in new work when he discussed his early research into sex. He’d studied the issue of human sexuality extensively for several years and was considered by many as an expert in the field. Reflecting on this time, he said in the Psychology Today interview:
“One day, it suddenly dawned on me that I knew as much about sex as any man living—in the intellectual sense. I knew everything that had been written; I had made discoveries with which I was pleased; I had done therapeutic work. This was about ten years before the Kinsey report came out. Then I suddenly burst into laughter. Here was I, the great sexologist, and I had never seen an erect penis except one, and that was from my own bird’s-eye view. That humbled me considerably.”
The other reason Maslow omitted the need to feel aliveness in his hierarchy was that his most passionate life studies were of what he called “self-actualized” people. These men and women, who represent a fraction of one percent of the population, were those who had converted their drivenness through the various levels of human needs all the way up to the need for self-actualiza¬tion. As such, they weren’t what most psychologists would con¬sider dysfunctional.
Yet it’s in the study of dysfunctional people—those in prisons, or those who are failing in schools, or who can’t keep a job or marriage together for more than a few months at a time-that we find the basic human need to experience aliveness most vividly painted.
Because these people never learned to express their need in higher ways, to transmute the energy of this need into the search for new chemicals or new theories of psychology or new lands, they demonstrate it in the rawest and most primal form. Maslow never looked at these kinds of people, even though they constitute a hugely larger population than his self-actualizers. Therefore it’s not only understandable that Maslow would overlook this basic human need, it’s predictable.
Solutions
Realizing that ADHD children and adults are being driven not by an urge to be bad, but rather by an inborn and unmet basic human need, we can view their plight with more compassion and understanding.
We can also look to ways to build more stimulation and variety into their lives, be it in the classroom, the work place, at home or in relationships.