davidberreby.com

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.5 License.

I wrote this piece in 2001 for a fine magazine, which decided it should be totally different in style and content. I didn't agree, so we parted ways. It meets the public for the first time right here, on the site.

Mighty Hunter, or Village Idiot? The Fight to Define Attention Deficit Disorder as a Human Kind

By David Berreby
(Written in 2001)

Not to be reproduced or posted without permission. Please email david@davidberreby.com for more information.

Part I

Thom Hartmann has Attention Deficit Disorder. So do his son and daughter. And, he thinks, his mother had it to. And all that’s fine with him.

More than fine, really. Hartmann, who was once a counsellor in a halfway house for troubled teen-agers, tells anyone willing to listen that ADD helped to make him the author, businessman and lecturer that he is today. He says ADD isn’t a disorder that’s messed up his life, like diabetes or Krohn’s disease. Rather, it is, as the subtitle of one of his many books puts it, "a different perception": a way of being, like tall or bald or female or black. ADD isn’t a burden he bears and fights against, he says; it’s bound into every strand of his life. It underlies his successes. Without it, Thom Hartmann wouldn’t be Thom Hartmann.

That’s the message of comfort and self-confidence he brings to children and to adults who have been diagnosed with Attention Deficit Hyperactity Disorder (or A.D.D., for those who have all but the fidgetty trait). You’ve been treated as if you were defective, but you’re just different. The problem isn’t you, it’s society, which has declared that The Way You Are is wrong. Hartmann -- and many other ADD therapists, counsellors, psychologists and psychiatrists -- have been getting a warm reception for this message for several years. Think of Hans Christian Andersen’s fable of the ugly duckling who is actually a swan, retold as if swans had support groups and a lobbying arm in Washington.

"I’ve literally had hundreds of people burst into tears in front of me, because they thought they were messed up and then they read my book and saw that they still had some humanity," Hartmann told me.

"Seeing ADD as positive is good for people," agrees John Ratey, a Cambridge psychiatrist and writer whose best-selling `Driven to Distraction’, co-written with Edward Hallowell, is a major reason ADD is now common in pop discourse. "ADD-ers have a background of undertainty, anyway. They’re never secure."

Most people I described this idea too nodded easily, even if they knew nothing about attention deficit. Whatever the specifics, the outline of standard Baby Boomer piety is familiar -- we all have our strengths and weaknesses, everyone has a contribution to make, let’s not call people "sick" who are just different. It’s the Hollywood movie version of society -- C3PO is cowardly and a complainer because he’s used to diplomacy (but that means he can speak any language the heroes need spoken); Han Solo is a skeptic and a crook, which means he can get round the bad guys by means the good guys never learned. Everybody gets a moment to shine. Whether or not you’re different depends on what kind of society you live in. One people’s homicidal loonie is another’s most decorated soldier. That’s our secular religion of tolerance and diversity, used to open up our society for many different social groups for the past three decades.

And Hartmann's message is such a standard psalm from our Book of Common Political Prayer that we doze through it without reckoning how thoroughly it contradicts an equally cherished American belief.

That other beloved truism is this: If you aren’t happy and productive and fulfilled, it’s because there’s something wrong with you, and Medicine can tell you what that is. The ADD-is-good stance tells you that the news will be welcome -- ``I’m not lazy or crazy, I just need treatment’’ -- that, in effect, you are who you say you are.

But we usually go to doctors in the expectation that we are what they say we are. And there’s a harsher view of ADHD out there, with the familiar shape of a bad diagnosis. This medical view of ADHD also has a champion.

"Thom Hartmann’s view that ADHD people succeed because of ADHD traits is like saying Ulysses S. Grant was a great general because he drank," says Russell Barkley, a psychologist at the University of Massachusetts Medical Center , editor of a newsletter, the ADHD Report, with some 6,000 subscribers among clinical professionals, and author of a shelf of books and articles on this disorder, for both layfolk and professionals. "So then to succeed all the rest of us should drink. That’s the connection he’s trying to make."

Barkley has been researching ADHD for decades. He too is the author of a shelf of books, both technical and popular-advice. He is also the originator of a controversial theory of ADHD that leaves no room for the idea that it offers benefits. Talking to him is like talking to an antimatter Thom Hartmann -- same conversation, just make all the positives negative. Sure, he told me, "I may encounter individuals -- athletes, millionaires -- who have ADHD. Their talents allow them to overcome impairment. But you can’t connect the talent to the disorder."

For a couple of years now, a public fight between Hartmann and Barkley has been embodying this contradiction in our beliefs about people -- you are what you believe you are vs. you are what the experts say you are. And like most arguments about psychology, it’s about real people’s fears and tears, not academic abstractions. Therapists who lean to the Hartmann view will tell a new-diagnosed child (or adult) that he’s felt like an Ugly Duckling because he’s really a swan. Therapists of the Barkley school will say, Face it, guy -- you are one defective duck.

The clash of truisms has a political dimension as well, well beyond the hundreds of thousands of diagnosed people (by the mid-1990's American doctors were writing six million prescriptions a year for stimulants to treat ADHD). Medical power over human traits is increasing every day. Surgical techniques now exist to make dwarves taller, and to give deaf children the ability to hear. A new generation of mind drugs will soon give psychiatrists far more to throw at whatever they deem a treatable mental malady (or even simply a normal condition that can be "enhanced"). Moreover, with the genome sequenced, doctors’ power to remove such traits as deafness and dwarfism from the gene pool is likely to grow. If ADD is a valuable way to be a person, or if deafness is a rich cultural tradition, then maybe ADD and deafness should not be medicated and engineered out of existence. On the other hand if ADD or deafness are maladies in all times and all places, then it’s only medical common sense to eliminate them.

And even as this conflict comes into focus, the number of categories we can argue about is proliferating, a result of new work in genetics, brain science and drugs over the past decade.

"Just a hundred years ago, we had diseases like consumption, pleurisy, quinsy, dropsy, which were diagnosed by reporting what anyone could see -- for example, `the patient has a cough.’ " says Peter S. Jensen, a neurobiologist at Columbia-Presbyterian’s Center for the Advancement of Children's Mental Health. "Now we say `tuberculosis,’ which is not about a surface description like `cough’ but about an underlying process or pathway. We begin to distinguish the cough of TB from a cough that’s caused by an allergy to the cough that’s a nervous tic. The underlying pathways are not the same. "

Psychology is not at that level of knowledge yet. But the prospect is dawning, and so we're now in a great flowering era of competing maps of the mind -- proposals for new categories of people and disorder, to be confirmed later, when all the data are in. ADD is not a new diagnosis (it was first defined around the turn of the last century) but it's in a turmoil now that reflects our era of competing models. Some doctors have proposed that ADHD is really two separate disorders; one researcher, using brain scans, says it’s actually six. Meanwhile others, using cultural arguments, claim it doesn’t exist at all -- that it’s a product of too much TV, too much sugar, or too much power for the drug companies that sell the pills used to treat it.

So a person with an ADHD diagnosis can read, in the course of a day, that she’s a hunter in a farmer’s world; that she has an unfortunate disability that she must work against all her life; that she had something serious as a kid but all kids with this grow out of it; that she actually has something much more specific for which ADHD is a general term, like "cough"; that she has nothing at all.

In a book published last year about these issues, the philosophers Allen Buchanan, Dan W. Brock, Norman Daniels and Daniel Wikler point out how much such categories matter, and how little has been settled. Their title sums up the situation: From Chance to Choice. The Barkley-Hartmann spat over ADD (is it good? is it bad?) illuminates one of those corners of our culture in which we have all tacitly agreed to disagree. But sooner rather than later, that will no longer be possible. New technologies -- drugs and genetics -- will force us to make up our minds.



Part II



Thom Hartmann was a young enlisted man at Lackland Air Force Base in the 1960’s, in basic training, when he had what feminist activists of that decade would call a "click moment."

"I remember getting a sudden realization that my country was hellbent on killing me," he recalls. "It led me to question a lot of things. " Hartmann realizes that to most Americans, this will sound familiar. "I came of age in the 1960’s," he says. That was when social movement after social movement exhorted people who had been taught to hate what they were. Feminists told women that they weren’t the weaker and more emotional sex, but different kind of people, who cared more about relationships than abstractions; the black power movement elevated exactly those aspects of African-American life that were supposedly low-class -- black English, kinky hair, soul food -- and made them badges of pride. Shame and silence about homosexuality was replaced by Gay Pride celebrations all over the world. Activists for the deaf described a deaf culture that more than makes up for the lack of hearing. For people in such movements, the central principle is: "Change society, not people."

When this group-making shades into group-mongering, it can sound primitive and silly, as when Larry Kramer announces that Lincoln was gay or an activist in the Little People of America asks if I knew that Attila the Hun was a dwarf. (Maybe Lincoln would be called queer in today’s context and Attila a little person. Maybe the ancient Egyptians would be perceived as black if they rode the F train, too; but these people did not see themselves in our frameworks, and so when we try to involve them in our quarrels we’re talking about ourselves, not them. We ought to leave the costume drama out of it, but we can't More on that later.)

Nonetheless, society’s many proliferating new tribes, from large blocs like trash-culture-proud Southerners to small ones like the Maple Syrup Urine Disease community, share the Ugly Duckling story in outline, however different the details. You are not alone, you are not bad; in fact, what you are, or were, or have gone through, is at least partly good). As earlier social movements had shown, if people have been taught to hate what they are, the duckling-to-swan story can help them stop.

For the past few years many therapists and prominent Americans who have been diagnosed with the condition have been working to extend the Ugly Duckling story to Attention Deficit Disorder. (Did you know that Thomas Edison had A.D.D.? That’s in one of Hartmann’s books.) Hartmann's argument is this: The symptoms of A.D.H.D. are defined as distractability, impulsiveness and a love of high-stimulation activities. (Hyperactivity, or the inability to keep still, is present in lots of ADD people but not all of them.) These traits aren’t much good in a society where people trudge out every morning to do the same monotonous crop-tending and fence-mending work that they’ve always done, nor for people who are supposed to work their way slowly through jobs in a giant industrial corporation. Distractability, impulsiveness and excitement-hunting aren’t, especially, good traits to have if you’re sitting in a classroom several hours each day. If Beowulf or Achilles showed up at Anywhere High School tomorrow, he’d be put on Ritalin, pronto.

But Beowulf and Achilles weren’t considered screw-ups. They got top billing in ancient epics, and this is Hartmann’s argument: ADD is a set of traits that serves people badly in some contexts but well in others. If you look at the three key ADD traits a little more sympathetically, you get constant scanning (instead of distractability); quick-acting (instead of impulsive) and challenge-seeking (instead of risk-loving). These traits have their moments, Hartmann believes. After falling asleep one night over a Scientific American article about our foraging, hunting ancestors, he woke up with another click moment. ADD traits are just what you need if your way of life depends on hunting. Their opposites -- stick-to-itiveness, prudence and tolerance for dull but necessary activity -- are perfect for farming.

And so one more social group is born: ADD people are Hunters in a world set up and run by Farmers. There are other version of the ADD-can-be-good story (among other spiffy names therapists have coined are "the Edison trait”). In their best-selling book "Driven to Distraction," which helped popularize the concept of ADD in the last 10 years, psychiatrists Edward Hallowell and Ratey have similar positive things to say about ADD, which is not to surprising, as they both have it. (More about that later, too.)

When Russell Barkley first heard Hartmann’s Hunters and Farmers theory, he says, "I figured it was pop psychology. We ignored it. Then we noticed ADHD advocates were using it to explain the disorder and to make people feel better. I noticed that it was being taken seriously by the practicing community." This bothered him, Barkely said, but he still shrugged it off.

"Then Peter Jensen published a paper suggesting that ADHD could have been beneficial in an earlier phase of human evolution," Barkley goes on. That 1997 paper shocked him; Hartmann was a mere pop writer, but Jensen is a leading figure in research on brain development.

"We withheld our criticism because at the time he was at the National Institutes of Mental Health, overseeing reearch in the field," Barkley tells me. "His hand held the pursestrings. But I reached a point where I said, `enough’! ‘‘

Things rapidly got out of hand. Barkley laid into Hartmann in his influential newsletter. Hartmann published an article in Tikkun, a magazine of Jewish social thought, in which he compared Barkley’s ideas to those of the kind of eugenicists that Hitler liked to cite. Things have been at the Punch and Judy ever since.

"This idea is a form of mental cocaine," Barkley told me. "If your aim is to make peope feel better, why not just give them a narcotic?"

What seemed to gall him most about the cultural argument is a whiff of an attitude that often sneaks into Ugly Duckling stories -- we say we're different, but we know different means better.

"You can’t have it both ways,'' Barkley told me. ``What they’re saying is ADHD makes you *better* than other people." His voice was rising. "If you do that you can’t go clamoring for the protection of the Americans with Disabilities Act. If it makes you so able, how can you say you’re diabled? It’s not only a paradox , it’s hypocrisy. Your disability is also an advantage? It’s a laughable idea. It can’t be an advantage and a disorder. Each term excludes the other."

Barkley conceives of ADHD as a disorder in the normal development of a child as its brain learns how to inhibit its reactions -- how it learns self control. The seeming paradox of taking stimulants like Ritalin and Dexedrine to calm down, he proposes, is explained by assuming that stimulants goose the activity of the upper cortex -- ``rational'' parts of the brain that keep `normal' people focussed on their tasks and goals.

In the Barkley model, that cortex houses four key "executive functions" that function to give a normal person’s the standard amount of self-control in its dealings with other brains. That’s important because human beings, like other members of our primate order, live by making alliances and exchanging favors. "Reciprocal altruism" -- I charge your dead car battery, you buy me dinner -- is the bedrock of the whole human social system. That is why, Barkley says, ADHD people can never be perfectly accomodated by society."It interferes with these basic tasks that help you make and stay in coalitions, and that help decide whether or not you return a favor."

Barkley's theory is much more systematic and ambitious than most others (if you think you've solved a mystery, you have an edge over people who think there's not enough information to attack the problem). That thoroughness, and his years of experience with patients, mean his predictions will ring a lot of bells for anyone familiar with the disorder. He expects ADD people to have ``time-blindness.'' Check. They will, he says, often go for the immediate payoff rather than the deferred goal. Check. They, and the people around them, will feel that the problem is (as he writes) not one of knowing what to do, but of doing what you know. Check. (A classic ADD comment is `I see what I need to do, but I just can't seem to get it done.')

The heart of his argument with Hartmann, though, is not about the science. It's a partly overlapping quarrel that both men recognize is political.

"So I decide ADHD is really an advantage, not a disability. I’m supposed to overlook the fact that you’re a lying, cheating, son of a bitch?" When Barkley said this to me, he was almost yelling. "So we’re not going to make you pay back your credit cards?" The inhibition mechanism, he repeats, "supports the ability to wait your turn, to listen. I’m supposed to overlook that you can’t do that? It undermines a very important human enterprise."

Barkley’s style is crisp, adamant, definite: human habits are either disorders or advantages, they can’t be both. In the first ten minutes of our phone conversation, he used the words "science" and "scientist" a dozen times. His manner is of a guy who won’t coddle you about the world’s hard truths. That style, and the words `reciprocal altruism,’ remind me that he has hitched his wagon to Evolutionary Psychology, the intellectual movement that frames all human acts in terms of "fitness" -- whether they help or hinder a person in passing on copies of her genes.

Ev Psych plays well in interviews, and in articles like the one you’re reading, for a simple reason: Journalism is built on the idea that there are facts out there to be discovered and retailed, and that you get those facts from people with credentials. Ev Psych is hell on ambiguity. And it always sounds so, you know, scientific. Barkley goes on: "It was William James, more than 100 years ago, who said when there’s dispute and confusion, the first thing you should do is define your terms."

Ev Psych and journalism mix all too well. It's a mesh of styles, not a sign that the truth is settled. Ev Psych arguments sound airtight because the terms are defined neatly, but that neatness doesn’t make them right. For example, "disorder" and "advantage" are mutually exclusive only if a disorder on Tuesday is a disorder on Thursday is a disorder five years from now -- it requires a standard that never changes.

So Barkley’s logic left me cold. That doesn’t feel like anybody’s life that I know. In the real world, a single-minded, bad tempered lawyer can be lousy company at dinner but a great guy to have sitting next to you when you’re answering an indictment. Just because Ev Psych has a hard clarity that fits the needs of an article like this one is no reason to decide that Ev Psych approaches are correct. We should not confuse ease-of-use with accuracy.

I also knew that the invocations of all-conquering science in Ev Psych are overstated. Lots of scientists don’t buy the program. The dean of evolutionary psychology, John Tooby, head of the Ev Psych organization, the Human Behavior and Evolution Society, acknowledged as much after a magazine article he didn’t like appeared in 1999. Writing in the HBES newsletter about the arguments of skeptical scientists, Tooby said: "What is important to recognize is that these arguments have won the hearts and minds of large numbers of neuroscientists, biomedical researchers, anthropologists, psychologists, linguists, and even a substantial number of non-evolutionary biologists."

Though Barkley, a Ph.D. in psychology, can easily out-credential Hartmann, he can’t be as cavalier about the objections of psychiatrists like Ratey and neurobiologists like Jensen. And their doubt is the one many biologists will express about evolutionary psychology: We don’t know enough.

"It’s really much more complicated than Russ would have people believe," Jensen told me. "This is the brain we’re talking about. It’s not the heart, which has maybe 10 interrelating systems -- the brain has hundreds." Inhibition and motivation are not all there is to concentrating on a task, he said. "There’s also honing in, getting some neurons to work at a fever pitch. So when someone says `this is IT,’ I think we need to be a little more humble than that."

Jensen also had his doubts about the neatness of Ev Psych logic. "Russ said, `waddya mean, ADHD is adaptive? You think it’s adaptive to be impaired and adapt badly to life?’ Well, when you ask *that*, the answer is no. But if the question is, `might rapidly shifting attention serve some purpose?’ Then the answer could be different. ‘‘

He reminded me that high blood pressure is clearly a genetically based disorder. "And it’s quite clear that having a capacity for salt and water retention was adaptive in some circumstances. But we no longer live in an environment in which those circumstances arise very often." So high blood pressure is a disorder, caused by a mechanism that probably served some useful function in the human past. So, Jensen says, "to say it might have had some adaptive value is not to say it’s adaptive now, or adaptive in all circumstances. Context always matters."

I found this persuasive. But then, I had a third reason for resisting Barkley's notion that ADD is a disorder, pure and simple. One that was more personal.



Part III



I was diagnosed with attention deficit disorder in the summer of 2000, after I'd read Hallowell and Ratey’s best-seller, and Barkley’s scholarly `ADHD and the Nature of Self-Control', and a couple of Thom Hartmann books and a lot of other material. I put off seeing a specialist for a long time. The fear of stigma, of being marked as "not right," is real. Yet the actual diagnosis came as an immense relief. That a kindly psychiatrist (who came straight out of central casting, with a Park Avenue office and a German accent) had a name for what was troubling me meant that it was something real. I had a feeling of vindication that reminded me strangely of having a good idea published and paid for: I am not imagining things. But the affirmation that comes with publication is attention and a check (especially the check). This one, coming from the House of Psychiatry rather than a bunch of editors, felt warmer: We can help you. Another Hollywood cliche comes to mind: Thirty-four doctors say nothing can be done, but then, one day, our hero, who has whatever-ailment-of-the-week, meets the one doctor who knows what to do.

On that day, the competing visions of ADD felt as far from abstract as any words can be. I felt them wrestle in my chest, where my breathing was shallow and my heart was beating hard. Dread: There’s something wrong with my brain. (All the exes and editors who’ve said so were right!) And relief -- it isn’t just confusion, it isn’t normal to-ing and fro-ing. (One of the many pop books that ADD people recommend to one another is called "You Mean I’m Not Stupid, Lazy or Crazy?")

The Ugly Duckling to Happy Swan stories we tell are different in their details, and being black is not being female is not being gay is not being in a wheelchair is not having a behavioral disorder. Yes, the differences matter. But the stories do have a few points in common, and one of them is this: They involve accepting that what you are is something you know other people hate -- something, very likely, that you were taught to hate yourself, and tried. Something, you know, it would be easier not to be. An act of self-acceptance turns around the old self-contempt, that lifelong apologetic shuffling ("yes, yes, I know, I’m acting kind of like those awful people we don’t approve of"). You look back and suddenly you feel contempt for the shuffling. You think: The time I wasted, trying to play on the wrong team. (This is much easier to face once you’ve decided there’s such a thing as a right team. It’s way easier to be sure you’re not just a weird duck once you’ve seen a few swans.)

Because, yes, another cliche, I had always known I was different, even as a 10-year-old. Starting things and not finishing them. Never really awake before 11 A.M. and always doing homework at midnight. I felt that my life moved in fits and starts,. and that other people were steadier in their efforts. Read a chapter a week and then report on the book, as opposed to what I did, which is read a page or two and then stay up with the book the night before the test. Motivated by absolute panic or someone’s rage, I could pull together for a while. But that’s what it took.

All of which sounded like a serious case of being a kid, and then of being an adolescent. I was unreliable about homework but it often turned out well, and I always shone in tests and in class (right here, right now, as opposed to work that takes planning). I thought my life had an unusual number of roads that ended nowhere but I told myself, it’s my family, it’s our times, it’s my age. I had a few quirks, sure: Whenever I'm in an audience that claps to music, my hands are together while everybody else's are apart. It always seemed to take me three times as long as anyone else to learn how to perform any physical activity or sport. I couldn’t find my way out of a paper bag, even if it had "How To Get Out of this Paper Bag" printed clearly on the inside. But none of this made me feel like anything but a more or less typical teen age male.

Then I got to college.

I went to one of the universities that shunts people into the American elite. You've heard of it. Presidents went there (including some rather recent and annoying ones). So one sunny September day I arrived fresh from my hippie-dippy California high school where we chanted `Om’ before Chemistry class to a campus of tight-wound mega-achievers. Many of them had been trained since the single digit years in all the arts that felt quite pointless to me: Planning for the Future; Managing Your Time; Making Priorities.

I had never done any of these things. I had always operated in either what I would now call Good Mode or in Bad Mode. Good Mode was doing what felt right and fitting to do -- not necessarily easy, like watching a movie, but certainly absorbing, like doing class reading that was truly fascinating. Bad Mode was doing what had to be done because someone was screaming about it, or threatening earnestly to have me thrown out of school or put in a reform school or assassinated.

What Good Mode and Bad Mode had in common, of course, is Now. They were both about responding to something urgent and immediate. Of course I could see that the future -- next week, next month, graduation day -- was real. But it didn’t *feel* real, at least not in a way that compared with whatever was before my eyes right now. I would make elaborate plans, some good, some bad, but the next morning the plan would feel no more real than a text in Urdu. Because, after all, away from the quiet of the planning session, some other signal would be stronger. A party tonight. Upset about some argument. A neighbor needing a hand with the groceries. I always paid attention to the loudest emotional signal, and the volume wasn’t up to me. (Relatives adapted by portraying their every desire as a national crisis.)

Other students moved their attention, seemingly at will. Mine, by contrast, was always "sticky" -- after we’d all watched Saturday Night Live in the lounge, other people would wander off. I would still be there at 3 a.m., unable to take my eyes away from the roaring fire of information under the antenna. I often closed the dining hall at lunch or dinner, and was the last to leave the party. I also closed the library at midnight. I closed a lot of different kinds of places. Whatever I was focussed on, I wanted to keep doing until it was done, to the very bottom of doneness.

Most of college, though, required an endless balancing act: film class and Spanish class and choir practice and a date and read some Keats for Thursday. I couldn’t imagine why anybody would want to live this way. I could see the necessity for dividing up one’s life into coffee-spoon doses, but I couldn’t feel it (and, OK, to be honest, I still can’t). In a college packed full of ambitious high-achieving students, this attitude soon posed certain difficulties.

A therapist was useless. He wanted to know how I felt about my parents and how often I masturbated. When I turned to the things that worried me the most -- how do I manage the day, how can I stick to a schedule, what if I use a timesheet -- he would scowl, as if these sorts of problems were beneath him. Drugs were no temptation. Alcohol and marijuana just made me feel stickier and slower. The only exception were the diet pills I would cadge to stay up all night at the end of a semester. They made me feel focussed; less vulnerable to the next emotional noise that drive by. I remember wishing there were some low-level speed I could take all the time. That turned out to be a prophetic hope.

Lots of people get into such difficulties. My irrepressible fondness for Bill Clinton comes from the pleasure I got out of seeing somebody like me in charge of the country. Revising the State of the Union a half hour before? Pardoning a bunch of scuzzballs in a mad rush, on no sleep? I feel his pain.

But there's a big difference between taking a lot of chances and having ADD. This is what it is: My screw-ups weren't new, they weren’t temporary, and the standard ways out didn’t work. Clinton may have been revising the State of the Union 20 minutes before giving it, but he gave it. He didn't say something like, `When I finally focussed on this I realized I can't really pull this together for another week. Sorry.''

Weeks after other procrastinators had pulled themselves together and hit the books, I was in the library, reading assignments for classes I wasn’t taking. The prospect of being kicked out of college, that middle-class death, soon lost its terror. The Vietnam War was winding down, so I wouldn’t be drafted. I thought I was pretty good at newspaper work, so I figured I could get a job (that happened, but it was dumb to think it was a sure bet). I found that one problem with being motivated by crisis is that middle-class life doesn’t offer too many genuine threats to life and limb. I knew, if I dropped out, that I’d get by. To worry about blighting your future you have to feel that the future is real.

I did eventually drop out and eventually returned and graduated (in part because changing my major involved a happy summer of taking one single class, intensively, every single day). I told myself I just wasn’t suited to academia, and went into journalism. But I knew, in my heart of hearts, that the difficulty wasn’t one of temperament or taste. For it wasn’t that some work was more congenial to me than others. Other people, I sensed, could force themselves to do what was uncongenial rather than be fired. I knew that I could not. People would roll their eyes and say, "of course you can! Just do it!" They were wrong.

So, I have a deeply personal stake in the ADD debate. It is, as for everyone else, both psychological and political. I would prefer to consider myself a Hunter rather than a Lamebrain, and I would rather live in a society where we ADD people are seen as having an equal part to play.



PART IV



Now, at this juncture, you might be thinking that matters look good for Russell Barkley. (If you have ADD, you have very likely not gotten to this juncture from the pages before; you probably read the headline, the ending, a photo caption, a random paragraph. *Why can't he get to the point?* I too read magazines backwards. Happy hopping to you.)

As for the rest of you, here is the case for Barkley: He has a well-developed theory (which I have only sketched) that requires him as a matter of logic to hold that ADD is a disorder. He also wants to protect his patients from attempts to take away the help they need (and given the popularity of the idea that ADHD is a myth, his political anxieties make sense). His scientific argument is controversial, but in the louder arena of pop psychology, his most noticeable opponents are all people who have a stake in how ADHD is categorized. Hartmann and Ratey have ADD themselves. So do I. It's an Ev Psych dream date: Scientific objectivity versus wishful thinking.

But there is a problem.

Russell Barkley grew up with a twin brother. ``Fraternal twin, not identical," he quickly says when I bring it up. And this brother had all the symptoms of ADD.

Now, it's a fact that one of the most frequent complaints you can hear about the ``ADHD is good!'' line is that it leaves other people in a ``coping family'' holding the bag -- ``he's a Hunter, while I'm just a Farmer, and so I should get with the program,'' as one angry wife wrote to the ADD support group on Compuserve last year. Hartmann says he's careful to tell people ``that they shouldn't use ADD as an excuse,'' that their brain architecture is a way of perception, not a free pass through life. Still, put-upon family members often feel they’re stuck in an exploding-cigar of a home.

I thought of Barkley's twin as he raised his voice to complain about society tolerating people who won't pay their credit card bills. And when I read this passage from his scholarly ``ADHD and the Nature of Self-Control'': ``If those with ADHD are like the first or second of the three little pigs in the children's fable of that name and the rest of us are like the third, their fate is clear even to a kindergartener -- they deserve the wolf that comes for them.''

Deserving the wolf doesn't sound too objective to me. Hartmann feels the same way, naturally. He says: ``The first time I heard Barkley speak was six years ago at a conference, where he mentioned his twin brother and what it was like for him. I thought, `I’m listening to a Smothers Brothers routine. You know, it sounded like he was saying `mom always liked you best!' "

"He has it," is all Barkley would say for publication about his brother. So doesn’t that affect his own attitude?

"I’ve been working in this field for many years and thinking about these ideas for a long time," Barkley says, his voice quiet. "I don’t think this has anything to do with my brother. Not that I’m aware of. Let’s not get Freudian about it."

OK, let's not. But let's consider the question it raises about the underlying argument: When we say, this trait is good, that one is bad, those are good people, these are bad, we're claiming a mantle of objective knowledge. That is the bedrock of Ev Psych -- ``fitness'' always means the same thing (passing on genes), therefore it can be measured the same way in all times and all places. But if human beings always get a little crazed when they contemplate other human beings, then can anyone really claim to be objective about anyone else?

Ratey thinks not. ``There's no way not to have an emotional bias about other people,'' he says. ``What we experience affects what we expect to see, and what we expect to see affects what we see.''

And that point relates back to the ADD debate -- is it a good thing, that makes you a Hunting-Edison-Entrepreneur? Or is it a Bad Thing, which you have to carry around on your back like a chattering, distracting monkey of self?

Away from the hard and fast arguments of those who want to be in charge of the terminology, after all, there is no short and final answer. In an interesting talk on identity a couple of years ago, Harvard's Henry Louis Gates Jr. recalled going, as a young undergrad, to a meeting of the Black Student Alliance at his college. Speaker after speaker hit on the subject of what was truly black, and whether this or that kind of conduct was black, and sufficiently so. Gates recalls: ``This friend of mine leaned over to me and said, `I don't know about you, Skip, but I've been black all my life. ' ''

Exactly. We're ourselves all our lives, whatever the people in charge of definitions say. Identities need definitions; we can't just make them up anew each morning. More important, we need them to *feel* real. That's why identity-mongers invoke gay Lincoln and dwarf Attila. When the kindly psychiatrist told me that this or that aspect of my behavior was ``classic'' ADD, I felt a warm, affirming, kind of tribal sensation welling up in me, and coming up behind, resentment for all the teachers and counsellors and friends and lovers who got it wrong: *Of course, I've always been this way,* is what I thought. If I had felt that we were just inventing a good story, I would not have been convinced. I needed to feel we were discovering some already existing truth.

So we turn to people who make definitions of identity -- to academics, politicoes, psychiatrists, all the devisers of categories -- to tell us things about ourselves that will feel magically right, as if we already knew them. But there is a gap between those people and the rest of us, as Gates' story implies. For their academic conferences and magazine articles and books, they need to exaggerate the clarity and importance of their ideas. They brush the exceptions and oddities under the rug. But the rest of us can't do that in our daily lives, because those exceptions and oddities are us.

So while Hartmann says ADHD is great and Barkley says it's invariably a bad thing, my own experience with ADD (and, I suspect, most other people's) is that it's both. My vices are my virtues, and vice versa.

And this I think is the problem anybody with any common sense must have about identity rhetoric. It's comforting, it's exciting, and it's interesting to see one' self in a new way (they said I wasn't OK but I really am! Or, they tell me I'm fine but I know I'm not!). But after the circus leaves town I am, as ever, stuck with my inescapable irreducible, admirable, contemptible, worthy and worthless self.