to Attend
People have, with the help of so many conventions, resolved everything the easy way, on the easiest side of the easy. But it is clear we must embrace struggle. Every living thing conforms to it. Everything in nature grows and establishes itself in its own way, establishing its own identity, insisting on it at all cost, against all resistance. We can be sure of very little, but the need to court struggle is a surety that will not leave us.
—RAINER MARIA RILKE, Letters to a Young Poet
“I HAVE SPENT MY WHOLE LIFE pretending to be normal,” said fifty-year-old Elizabeth, an interior designer. The pretense of normality is familiar to any adult with attention deficit disorder. She works at fitting in by toning down the strength of her feelings about matters that others seem to think unimportant, by struggling to suppress her intensity and by feigning an interest in what bores her to tears. The game is precarious. No matter how clever the alien becomes at attempting to pass as an earthling, some telling awkwardness in his manner, some fatal expression of his true nature will, in unguarded moments, betray him for what he is: different.
Although the soul-destroying fear of being different is shared by many in North American culture, conformism is less a painful struggle for those who really do fall in with social norms. Those who do not consciously experience themselves as different may also shrink from any temptation to be themselves, but they are not compelled to live every day aware of the mask they are wearing, tense for fear it will slip.
The irony is that the energy ADD adults expend on their attempts at sameness is wasted, as is the anxiety parents generate over their child’s differentness. The world is much more ready to accept someone who is different and comfortable with it than someone desperately seeking to conform by denying himself. It’s the self-rejection others react against, much more than the differentness. So the solution for the adult is not to “fit in,” but to accept his inability to conform. The child’s uniqueness has to first find a welcome in the heart of the parent.
None of this is achieved by an act of will, and it is possible one will not succeed completely. That is not important. What is important is to engage in the process, difficult as that is. Healing is not an event, not a single act. It occurs by a process; it is in the process itself.
By no means is it an easy process. A person with ADD does start off with a sense of isolation. It is good to realize that many other people have had the same experience, are having the same experience. There are millions in North America whose lives are affected by attention deficit disorder in one way or another. It is certainly helpful for adults with ADD, or parents with ADD children, to join for mutual support with others who must confront the same problems they themselves face every day. There is strength in numbers.
This strength in numbers is essential for another purpose, too. Beyond the question of individual psychological support is the issue of effecting changes in the way society in general views attention deficit disorder, and in particular how the helping professions view it. Current attitudes toward attention deficit disorder are characterized by foggy awareness, confusion and/or hostile skepticism.
The state of medical knowledge about ADD today reminds me of the way doctors used to conduct deliveries about twenty years ago, when I first began to practice medicine. It was routine to perform an episiotomy on every woman giving birth. “Time to make a little cut now,” I would announce as the infant’s head was ready to exit the birth canal. Having injected local anesthetic near the vaginal opening, I would then make an incision a few inches long, catch the baby and hand it to the nurse. Then I set to repairing the wound I myself had caused. This is what I had been taught to do in medical school; I knew no other way. I happened to learn from some midwives—in those dark ages still working illicitly in British Columbia—that an episiotomy is not necessary in most labors. Other surprises followed: women could deliver babies without their feet in stirrups or even without lying down. When there were no complications, the baby could be handed to the mother without being poked and prodded under bright lights and having plastic suction tubes shoved in her mouth. These heretical doctrines have since been validated by solid medical research, so doctors can now practice with peace in their hearts what midwives have been doing safely for hundreds of years. Years of pressure from pregnant women and laypeople have now established natural birth procedures in many hospitals—although far from everywhere.
Three conclusions may be drawn from that experience. First, the medical view of the world tends not to trust nature very much. Second, there are things in the world that are true, even if they’re not taught in medical school. Third, sometimes doctors have to be educated by the public—under duress, if necessary. Since I have become interested in attention deficit disorder, I have seen that the same lessons apply. They apply also in the educational system, and equally in the fields of psychology and therapy. People will have to demand the help they require, and they will have to educate the professionals from whom they seek help about the realities of their lives. Parents as well as adults with attention deficit disorder must insist that the world pay more attention to their needs, even as they learn how to pay attention to themselves and to their children.
I have learned through my own process that a goal in life cannot be the avoidance of painful feelings. For people like me with ADD, and for everyone else, emotional pain is a reality. It does not have to exclude joy and a capacity to experience the beauty of life. We each for ourselves have to discover the age-old wisdom that the thing is not to struggle against pain, but to be able to endure it when it is unavoidable. “Many parents have an especially hard time when their children are feeling sad and disappointed,” writes Stanley Greenspan. “It’s an especially hard situation for parents of sensitive children, because these children feel emotions so strongly. But parents can help their children come to grips with these difficult feelings, learn to tolerate a sense of loss and disappointment, and move on.”1 We don’t do our children any favors when we try to protect them from experiencing sadness or failure. What we really for want them when they feel sad is to be able to endure disappointment and hurt feelings, not to hide behind defenses, angry acting-out and driven behavior in order to avoid emotional distress. Not, in other words, for them to become ADD adults. It takes a lot of loving to help a child accept sadness, to know that it can be endured, that sadness, like all other mind states, is evanescent. It will pass.
Throughout this book, I have insisted on the connection between human relationship and attention. Love, it turns out, is intimately related to attention. In The Road Less Traveled Scott Peck brilliantly defines love as action, as the willingness to extend oneself in order to nurture another person’s spiritual and psychological growth, or one’s own. Extending oneself means to do precisely what we find difficult to do. Most parents do not need to be taught how to love their children in the feeling sense, but we can all use practice in how to be actively loving toward them in day-to-day experience. I hope people will find this book of some help.
Adults with ADD face the most difficult task of all: learning how to be loving toward themselves. This is the greatest struggle because it requires that we gradually shed the defenses we have come to identify as the self and venture into new territory.
To love is to extend oneself toward another or toward oneself, says Dr. Peck. It so happens that this is also the precise meaning of giving attention to another person or to oneself. The origin of the word attend is the Latin tendere, “to stretch.” Attend means to extend, to stretch toward.
If we can actively love, there will be no attention deficit and no disorder.