Exposed: the Dangers in Viewing ADHD as a "Disorder"
There’s a history of people identified as “defective” or “disordered” being “weeded out” of society. It has ranged from segregation and isolation to forced sterilization to outright genocide...
Last month, Psychiatric Times published an article titled “The Making of Adult ADHD: The Rapid Rise of a Novel Psychiatric Diagnosis.” It essentially asserts that adult ADHD is a fad being promoted by psychiatrists and drug companies eager to push medication on unsuspecting adults. They explicitly claim adult ADHD is:
“[A] case of disease mongering, when a condition that has never been observed is suddenly made popular overnight as a result of social, cultural, and economic reasons.”
They also take a swipe at people who definitely have ADHD (who aren’t chasing a fad), reverting to the original psychiatric claim that it’s a “disease” and a “disorder” rather than granting even the possibility that there’s an upside to an ADHD diagnosis in either children or adults.
This is part of a distressing trend that’s emerging among a group I refer to as “Neo-Darwinists,” who often imply or state flat-out that people with Attention Deficit Hyperactivity Disorder (ADHD) are genetically dysfunctional, or even less evolved than the rest of us, and thus have nothing to contribute to our culture whatsoever.
There’s a long history of people identified as being “defective” or mentally “disordered” being “weeded out” of society. It has ranged from segregation and isolation to forced sterilization to outright genocide.
This is not a history civilized people should want to repeat, but, even today, some are calling for ADHD adults to not have children, for fear that this “defect” will continue to spread. This is very much a “first step toward disaster.”
Others use the straw-man scare tactic of threatening that any discussion of ADHD which isn’t in a purely “sickness” frame could lead to loss of funding for special education for ADHD children, or loss of profits to pharmaceutical manufacturers and practitioners who make their living working with ADHD children.
This trend of arguing that ADHD is purely an illness or genetic failure without acknowledging any of the gifts and competencies associated with it is destructive to our children and dangerous to our society. Because many of these neo-Darwinists begin their work by either citing or (more often) condemning my work, I must respond on behalf of our children and those of us who are adults with ADHD.
In the Seventies, when I was Executive Director of a residential treatment facility for disturbed children, I supervised a study of ADHD kids and the Feingold Diet (it only worked for one kid). It was published in 1981 in The Journal of Orthomolecular Psychiatry.
As the result of my son’s diagnosis in the 1980s, however, I went a step farther and developed a metaphor to explain ADHD to children, a metaphor which I subsequently published in my first book on the topic in 1991.
The metaphor was that hyperactive kids were actually “good hunters,” whereas the very steady, stable, classroom-capable kids were “good farmers.” Both, I said, are essential to a functioning society.
The hunters, I suggested, would do great in the forest or battlefield: their constant scanning (“distractability”) would ensure they wouldn’t miss anything; their ability to make instant decisions and to act on them (“impulsivity”) would guarantee they’d be able to react to high-stress and response-demanding situations; and their love of stimulation (“need for high levels of stimulation/risk-taking”) would cause them to enjoy the hunting world in the first place. (At its core, ADHD is diagnosed by evaluating the intensity and persistence of these three primary behaviors.)
I told these kids, however, that they needed to learn the basic “farmer skills,” because the world has been taken over by the farmers. Even our schools were organized by the farmers: schools let kids out in the summer so they can help bring in the crops! And factories and cubicles, of course, are just an Industrial/Technological Age extension of the boring, repetitive skill-set useful in agriculture.
The evidence that ADHD may be genetic, and my own experiences over the years visiting with indigenous agricultural and hunter/gatherer people on five continents, caused me to even think it possible that my metaphor might also prove to be “good science,” although I have little certainty about whether it’s genetics, culture, or both which so often causes indigenous people to fail when put into European-style classrooms. (I suspect both.)
Since the publication of this metaphor, I’ve presented it to tens of thousands of people at conferences on ADHD, neurology, and psychology from Australia to Israel to England and Argentina to virtually every major city in the United States.
During these lectures I suggested that perhaps in ancient times there was some sort of a “natural selection” process involved, to borrow a phrase from Darwin. I suggested that in hunting societies, those very risk-averse, super-methodical, check-it-five-times-before-doing-it people would not be particularly successful as hunters, and so would die off and not pass along their “farmer” genes.
On the other hand, in the careful, stable farming societies (such as Japan over the past 3000 years), those wild-and-crazy hunter-types would be weeded out, executed, or expelled and the culture would be left with a lot of very compliant followers and worker-bees but few inventors, innovators, leaders, or — well — hunters.
I now realize, however, that I should never, ever, have used a phrase invented by Darwin, because it just gave more ammunition to those who argue that ADHD is purely a disorder with no upside at all. Here it is again, for example, implied as a genetic disorder in this September Psychiatric Times article.
The banner of natural selection has now been picked up and twisted sideways to justify the world-view of some in the ADHD field that people with ADHD are suffering from a genetic defect that’s all disorder and not at all useful.
This defect, some who push this view of ADHD say, is the result of evolution — which occasionally produces “more fit” and “less fit” members of a species. (Normally the “less fit” die out or are dominated by the “more fit,” according to this interpretation of Darwin’s work.)
This is the natural course of the evolutionary process, they say, and the sometimes-explicit and sometimes-implied message is that those with ADHD are less evolved, and that humans who do not have ADHD are more highly evolved, in Darwinian terms.
This is alarming because the concept of variations in the quality of human evolution is the primary tenet of the doctrines of eugenics, a term coined in 1893 by Sir Francis Galton (1822-1911), the cousin of Charles Darwin. Galton derived the word from the Greek “eugenes,” which means “to be well born,” and promoted eugenics as “a civic religion based on science.”
He wrote that one day eugenics would replace Christianity, because of eugenics’ emphasis on selecting out only that which is “good, strong, and useful,” while “selectively deleting” from society those genetic characteristics which tend to “weakness, physical or mental.”
Eugenicists assert that nearly all human traits are inherited, including (to quote Charles Davenport, an American associate of Galton’s): “eye color, hair, skin, stature, weight, special ability in music, drawing, painting, literary composition, calculating, or memorizing, weakness of the mucous membranes, nomadism, general bodily energy, strength, mental ability, epilepsy, shiftlessness, insanity, pauperism, criminality, various forms of nervous disease, defects of speech, sight, hearing, cancer, tuberculosis, pneumonia, skeletal deformities, and other traits.”
Havelock Ellis wrote one of the classic early texts on eugenics in 1911, The Problem of Race Regeneration, in which he echoed what was then termed the “Social Darwinist” notion that genetic weaknesses or lower evolutionary status could cause people to fail in modern society.
“These classes,” Ellis wrote, “with their tendency to weak-mindedness, their inborn laziness, lack of vitality, and unfitness for organized activity, contain the people who complain they are starving for want of work, though they will never perform any work that is given them.”
Long before the modern neo-Darwinists suggested ADHD was evidence of the genetic and evolutionary inferiority of certain humans, America had already delved deeply into experimentation with eugenics as a tool for social change and to “improve” the human race.
In the 1920s we were the world center of eugenic activity: between 1907 and 1940 more than 100,000 Americans were involuntarily sterilized in more than thirty states. State bureaucracies determined who would be sterilized and who could breed; the banner of building national racial superiority was picked up in England, Finland, Sweden, and a dozen other countries by 1930.
By 1931, two years before Hitler seized power in Germany, twenty-seven states in the United States had passed eugenics laws including forced sterilization programs.
This did not go unnoticed in Germany: in Mein Kampf (“My Struggle”), Hitler wrote:
“I know people do not like to hear all this; but there scarcely exists anything more thoughtless, more hare-brained than our citizenship laws [which allow non-Aryans German citizenship]. There is, however, today one state in which at least weak beginnings of a better conception are noticeable. Of course, it is not our German republic, but the American Union, in which an effort is being made to consult reason.”
By 1936, Hitler had turned evolutionary psychiatry and eugenics into a state religion — as envisioned by Galton — and by 1940 he had produced huge human breeding farms, recruiting over 100,000 blonde women between fifteen and twenty-two years old to be impregnated by members of the SS, all of whom could prove their “Aryan blood” back to the mid-1700’s.
Before the existence of Hitler’s death camps became common knowledge in the United States in 1945, eugenics had picked up considerable steam and was a popular topic among psychiatrists and psychologists here.
As in Germany, the debate had by then expanded from the wisdom of breeding better humans to include the topic of preventing or doing away with those who were evolutionarily inferior. For example, Psychiatrist Foster Kennedy wrote, in a 1942 edition of The American Journal of Psychiatry:
“I believe when the defective child shall have reached the age of five years—and on the application of his guardians—that the case should be considered under law by a competent medical board; then it should be reviewed twice more at four-month intervals; then, if the board, acting, I repeat, on the applications of the guardians of the child, and after three examinations of a defective who has reached the age of five or more, should decide that that defective has no future or hope of one; then I believe it is a merciful and kindly thing to relieve that defective—often tortured and convulsed, grotesque and absurd, useless and foolish, and entirely undesirable—of the agony of living.”
The Journal ran an unsigned editorial in the same issue of this official publication of the American Psychiatric Association, enthusiastically endorsing Kennedy’s suggestion that useless, foolish, and entirely undesirable humans be “relieved” of the agony of living.
After World War II exposed the horrors of the end-point of this logic, however, proponents of eugenics became rather quiet, although there are still, today, active — albeit low-profile — Eugenics Societies in the United States and England.
The only high-profile American scientist since the 1950’s who was willing to publicly suggest that we should continue our U.S. eugenics programs was Nobel Laureate William Shockley (1910-1989), a physicist at Stanford University. After winning his Nobel Prize in Physics (not genetics), he openly suggested people with IQs lower than 100 should submit to voluntary sterilization.
His widely-published views gave encouragement to the quiet but ongoing eugenics programs in the US which were only stopped in the 1960s with the revelation by Attorney General Robert Kennedy that over 100,000 poor Blacks, Native Americans, and mental patients had been sterilized without their knowledge or consent, as doctors in thirty states doing the sterilizations told their unwitting patients that they were performing “a slightly painful pelvic examination,” or “routine surgery to prevent later disease.”
Since the first publication of The Bell Curve in 1995, however, it has become safer and more popular for those who believe there are evolutionarily inferior humans to “come out of the closet.”
For example, citing race as proof of evolutionary status, Michael Levin, in his 1997 book Why Race Matters, says, “Not one of the 1500 discoveries listed in Asimov’s Chronology of Science and Discovery (1989) was made by a Negroid people.”
Of course, this kind of racist neo-darwinism is not purely a German or American phenomenon. In Japan, there is today a best-selling book that is currently unavailable in English translation, even though it has sold tens of millions of copies in Japan. Titled The Japanese Brain by author Tadanobu Tsunoda, the book asserts that the Japanese “race” is superior to all other Asian races, who themselves are superior to Caucasians, who are in turn superior to the rest of darker-skinned humanity.
In the field of ADHD, the neo-Darwinists argue that the most evolved people are those capable of long and sustained focus and attention to boring tasks, such as would be necessary to obtain advanced academic credentials, for example.
Those on the branches of the human genetic tree who didn’t “evolve” sufficiently to excel at farmer-style pursuits, are, according to these authors, “impaired” by comparison. The author of one article, Russell Barkley, baldly states: “ADHD, rather than representing an adapted evolved set of valuable qualities, reflects weaknesses in the evolution.…”
The arrogance of the hypothesis that ADHD is an indicator of a less-evolved person is breathtaking. The fact that such analysis draws on the theory of eugenics should be enough to discredit it.
A less obvious criticism is that such a hypothesis assumes that the narrowly-defined criteria for success or failure in our particular culture at this particular point in time are identical to those of all cultures, all humans, and for all history, both past and future.
Cloaking themselves in the respectable mantle of science, the neo-Darwinists suggest that only in a rigorous application of the scientific method to the study of evolution will we find the ultimate answers to why people with ADHD appear to perform poorly compared with their non-ADHD peers.
“Serious and scholarly evolutionary thinking about ADHD” is necessary, according to an article by ADHD guru Russell Barkley, but must be constrained by an understanding of the “complexities of evolutionary theory,” and “the processes of natural selection” for us to gain true insight into population genetics and whether a particular trait is adaptive or maladaptive.
Nature is king, nurture is dead, and culture is irrelevant.
Even if the natural selection process with regard to the genetics of ADHD were true, the belief that ADHD represents a “defect” rests on a profoundly flawed assumption: that our culture and society is the pinnacle of an evolutionary process.
This better/worse view of ADHD assumes the evolutionary process dictates that the “most fit” will be the survivors or, at the very least, the most prosperous, and that now is the end-point time by which we must judge the fruits of natural selection.
“But Darwin says the victors must be the most highly-evolved!” shout the Neo-Darwinists, whether using their theories to justify why the rich “deserve” their riches, or why “defects” like ADHD should be medicated or bred out of our population. The easy response to that is: “Was Hitler’s Germany more highly-evolved than Poland or Holland?” The scientific response is: “Darwin said no such thing.”
David Loye, a founder of the General Evolution Research Group, points out that in Darwin’s seminal book on evolution and humans, The Descent of Man, Darwin discusses “love” ninety-five times and “morality” ninety times, versus two times for anything about the “survival of the fittest.” In one of these references to the “fittest,” Darwin says that “at the level of the human, other things become more important [than physical strength or intellectual ability or willingness to conquer or dominate], including compassion and spirituality.”
As Riane Eisler has so brilliantly documented in her book The Chalice and the Blade, a vast body of anthropological and archeological evidence points to human cultures and entire civilizations which were not exploitative, hierarchical, male-dominated, controlled by fear and power, or engaged in warfare. Indeed, today many are still here, represented by over 1,000 different indigenous societies in remote parts of the world.
Only a tiny minority of these indigenous cultures regularly engage in warfare or have hierarchical political structures: the vast majority are egalitarian, peaceful, and quite successful in their ways of life, those ways having sustained them for tens to hundreds of thousands of years.
In other words, there are different ways to live from the way which we live. There are — and always have been — different human cultures than our own. But, while Older Cultures value cooperation and security, our culture is set up to honor and support competition and domination largely to feed resources to the most wealthy and powerful.
Those people who are the most compliant and demur to authority figures are valued our society and schools; they do not have “Oppositional Defiant Disorder.”
Those people who can sit in a classroom for hours at a time, year after year, and then as adults sit in a cubicle or on an assembly line for hours at a time, year after year, are valued: they do not have “Attention Deficit Hyperactive Disorder.”
Those who have the ability to work easily and quickly with words and numbers are valued: they do not have “learning disabilities.”
Isn’t it interesting that we have no diagnostic categories for “musically disordered,” or “painting deficit disorder,” or “creative thinking deficit disorder”?
These abilities do not produce good, compliant workers for our corporations and institutions, which are the leaders and definers of our culture. Therefore we don’t even bother to measure or try to remediate deficiencies in them.
It is one thing to say that, “We agree as a society that this or that trait or behavior is the best thing for our culture as it is set up, and some other trait or behavior may not be as desirable for our culture.” It is quite another thing — a huge step over a very dangerous line — to say, “God or nature or science have demonstrated that this trait or behavior is absolutely good, and that trait or behavior is absolutely bad.”
These dangers are clear in Russell A. Barkley’s book, ADHD and the Nature of Self-Control. Barkley retells the story of the Three Little Pigs, but gives the first two pigs symptoms of ADHD while presenting the third little pig as being “like the rest of us” (presumably the author does not believe persons with ADHD would ever read his book). Given this scenario, he writes, the two little ADHD pigs’ “fate is clear even to a kindergartner—they deserve the wolf that comes for them.”
As we move increasingly from the realm of difference to the realm of disorder, some physicians have now come forward to suggest that people with ADHD should be encouraged not to have children, lest their “genetic weaknesses” or lower evolutionary status be conferred on future generations.
One such voice is Dr. David Comings. The thesis of his book, The Gene Bomb: Does Higher Education and Advanced Technology Accelerate the Selection of Genes for Learning Disorders, ADHD, Addictive, and Disruptive Behaviors?, is that people of “undesirable behavior” tend to have less education and to produce children at an earlier age (they are impulsive, after all) than well-educated persons, and therefore have more children.
This, he argues, produces a surplus of “undesirable” people, carrying “undesirable” genes, among our population. (In his writings, ADHD is explicitly deemed “undesirable.”) Comings cites and praises the writings of numerous modern eugenicists in his book, including Frederick Osborn, A. Coale, and D. Kirk.
If only we could get rid of those rabble-rousers, the neo-Darwinians suggest, then the rest of us could have a civilized life! Get rid of those who couldn’t make it in school (Thomas Edison was thrown out of school in the third grade, as was Ben Franklin); get rid of those who are incompetent at factory or office work (Vincent Van Gogh never held a job for more than two months); clear our gene pool of those who have no respect for legal authority (George Washington was sentenced to death by the King of England for treason).
Then, they say, when we’ve weeded out the ADHD Hunters, America will have an orderly society, an entire nation of third-little-pigs and well-built brick houses.
Too many psychologists, writing in respectable publications, insist that people with ADHD can make little or no contribution to modern society. ADHD guru Russell Barkley, for example, called my farmer/hunter model a “Just So Story” after the fictional fables by Rudyard Kipling. These authors and others like them flatly state: “In not a single instance of peer-reviewed, published literature have symptoms or consequences of ADHD been found to hold an advantage.” *
There are several problems with this assertion. The first is the word “advantage.”
Of course, they mean “advantage” in the contemporary cultural context of a person’s ability to function in a public school or work in a factory or office cubicle. In fact, virtually all the studies which have been published in the peer-reviewed literature of psychology are looking at the ability of an ADHD child to function in a “boring/farmer” environment, as this is what society rewards and so is our current criterion for “good.” Failure in this arena makes one a potential customer for the drug companies that fund such research.
No studies, to the best of my knowledge, have bothered to test ADHD kids against “normal” children on, for example, their ability to outscore in one of the new, high-stimulation video games or outperform on a skateboard — yet we all know how brilliantly these "impaired" children can function in these “non-useful” areas. In the real world, if these children could survive the experience of public school, such behaviors could translate into being a competent air-traffic-controller, detective, author, or combat soldier.
Since all the studies are looking for “impairment” in a specific and narrowly-circumscribed range of capabilities, it should surprise none of us that most find impairment — particularly since the children being tested were identified as ADHD by virtue of that “boredom impairment” in the first place (by their teachers or parents, who then referred them for testing and/or medication).
In a letter to the editor of Scientific American magazine, psychologist Russell Barkley says, “some studies have shown that ADHD can reduce IQ scores by an average of seven to 10 points.”
Of course, what the writer overlooks is the fact that the first thing an IQ test measures is the ability of a person to take a test: this difficulty taking tests, in and of itself, does not necessarily indicate lower intelligence unless one (rather stupidly) defines “intelligence” as only meaning the ability to sit quietly at ones’ desk to take tests.
No studies I know of have looked for ADHD children who are functioning well in school, or ADHD adults who are functioning well in life (although we all know of examples of the latter, from actors to entrepreneurs to inventors to artists).
Because publications of the psychology and psychiatry industries concern themselves only with pathology (there is no listing for “normal” in the Diagnostic and Statistical Manual of The American Psychiatric Association, for example), it should not surprise us that they find it. Nor should it surprise us that they wouldn’t bother to look for or at those who are not “failing” in society, and thus not potential customers for therapy or pharmaceuticals.
Thus, people like multi-millionaire entrepreneur Wilson Harrell (former publisher of Inc. Magazine and founder of the Formula 409 Company) are completely overlooked.
Harrell, in his book For Entrepreneurs Only, devotes two chapters to his own ADHD and his belief that ADHD is “essential” for the success of an entrepreneur. Similarly, those who don’t care to look for ADHD among the ranks of the successful would overlook Harvard psychiatrists and professors of psychiatry, Drs. John Ratey and Edward Hallowell, authors of the best-selling book Driven to Distraction, in which they state explicitly that they each “have ADHD.”
In fact, several studies have provided us with hints that ADHD may be useful somehow, somewhere, sometime. One of the most interesting was a Washington University study in which ADHD persons were tested against “normal” controls for their ability to handle emergencies: what the study’s authors called “urgent tasks.” The abstract reads:
“Attention-deficit hyperactivity disorder (ADHD) has been proposed to represent adaptive responding to highly urgent situations in primitive hunting societies. In the present study, 31 adults with self-reported ADHD were compared with 33 normal adults on a newly developed, 10-item measure of urgent task involvement. The internal consistency of the scale was suitable, and the group with ADHD scored significantly higher than the control group, as predicted.”
While this was the first study to demonstrate that people with ADHD had some advantage in some circumstances, many previous studies offer tantalizing glimpses which the researchers chose not to pursue.
For example, one study found that while “normal” children’s ability to read or perform tasks requiring vigilance deteriorated when they were “distracted” by high levels of external stimulation, ADHD children’s scores actually improved in a high-stimulation environment that challenged the Farmer kids.
Another study found that boys with ADHD calmed down when they were in highly stimulating environments, whereas “normal” children would crash-and-burn under such circumstances.
An article in The Journal of Creative Behavior by the University of Georgia’s Bonnie Cramond asks the question in its abstract:
“There are so many similarities in the behavioral descriptions of creativity and ADHD that one is left to wonder, could these be overlapping phenomena?”
The article goes on to suggest that a thorough search of the literature in both fields would imply the answer is “Yes!” It concludes:
“Perhaps individuals who have trouble with verbal learning but have a very imaginative, visual manner of thinking will be considered at the forefront of innovation in our society rather than as problem learners. Taken together, the results of these studies and others like them are indicative of a childhood syndrome characterized by hyperactivity and high intelligence, in which personality variables, modes of cognitive representation and creativity are intimately bound.”
Instead of trying to rid ourselves of ADHD children, our society would be far better served were we to ask, “How can we acknowledge and honor the individuality of each of our children, and provide settings in which each can develop into a happy, effective, and caring adult?”
Were we to provide education that acknowledges the differences in the way people learn, we might soon be tapping a source of creativity that could be useful to our entire society.
But to do that would require that we open ourselves up to the possibility that the kinds of skills we reward today may not be the only worthwhile skills — and that would open the question of whether the way we organized our society itself was the only or best way to create a society.
When such questions are on the agenda, ADHD children look much more like a symptom of a society which itself may be severely dysfunctional. If we cannot find the tools to reorganize our world immediately, we at least ought to do what we can to push back against educational and eugenic philosophies that might seek to obliterate those who do not fit into this distorted reality.
* Goldstein S, Barkley R.A. ADHD, Hunting and Evolution: “Just So” Stories. ADHD Report. 1998;6:1–4