
Attention. Please.
I was blessed with the opportunity to spend three hours with Gabor Maté this week (Online. Me and several thousand others. It was still a treat!). Most know him for his work with addictions1. But he is also known for his work on attention-deficit hyperactivity disorder (ADHD) 2.
He talked about his own diagnosis of ADHD. How knowing what was wrong and having a way to treat it made it possible for him to become an author. Medication helped him write his first book.
I’m trying to write a book…
He wrote four more books. Most recently he published The Myth of Normal3. He didn’t need medication to write it.
The brain can change.
Our model of the brain is changing. We used to think that the brain stopped growing after adolescence. We now realize that brain growth continues throughout life. The brain grows continuously. Nerves make new connections throughout life.
A comedian said, “I’m a man. But I can change. If I have to. I guess.”
I’m a man. Can I change? Maybe I can. Maybe you can teach an old dog new tricks.
Change is possible. The hand we are dealt isn’t simply a matter of genetics. There are only 70,000 genes in the human genome – not enough to account for all the variation we see in people. Our biology interacts with the environment, and this makes us who we are and also allows us to change.
This is “neuroplasticity”. You can change.
ADHD is a neurodevelopmental disorder. Genetics play a role. But they don’t determine the final outcome. Studies with monozygotic twins show only 51% concordance – that is, a person who has the genes predisposing them to develop ADHD is still only about 50% likely to develop it. The environment has a huge effect.
Stress during pregnancy can predispose the fetus to develop ADHD. The mother’s cortisol, released during stressful situations, crosses the blood-brain barrier and influences the development of the fetus’s brain. It becomes more able to react quickly to stressful situations. It’s adaptive. Knowing that it is about to be born into a stressful environment, the baby brain prepares itself to hit the ground running.
Brain development continues after birth. Raising kids is both intensely rewarding and intensely stressful, on parent and child. The ideal way to raise a child, Maté said, is with a village of parents. For most of human history we lived as small bands of hunter-gatherers; everyone in the group shared the parenting. This was ideal. Now, our culture is not so ideal for childrearing. Independence is overvalued. Parents and children are isolated from community supports that could mitigate stress.
Our culture is continually raising the stress level. This probably partly accounts for the increased diagnosis of ADHD.
Maté was careful not to guilt parents. It’s not our fault that the culture is high-stress. That’s what we have to work with.
He did a brilliant job of reframing ADHD in the context of genetics. Genes affect sensitivity. ADHD kids are generally more sensitive – more affected by the environment. These kids feel more. This makes them more creative. More intuitive. Also, alas, more reactive to environmental stress.
We can look at the increased sensitivity of a person with ADHD as increased responsiveness to life. These kids are more responsive. They live more fully.
We can look at their inattentiveness as a coping mechanism. They are so sensitive to their environment that it overwhelms them at times. They have to tune out.
Impulse regulation isn’t something we are born with. We learn it. Attachment – surrounding a vulnerable child with protective adults – allows the child’s brain to access the more mature functions of the parents.
For this to work, the parents have to work on their own maturity. Continuously.
The Buddhists believe that all brains are hyperactive. They talk about “monkey mind”. We have to learn how to tame our monkey brains. Being an adult with even a partly tamed brain is of immense value to a child who is still learning to tame their own brain.
So, said Maté, if you want to help your kids, work on yourself.
- In the Realm of Hungry Ghosts, https://a.co/d/02ULZxZv ↩
- Scattered Minds. https://a.co/d/0fZPmjFv ↩
- https://a.co/d/0cDDPcmZ ↩


