Fix the Brain or Fix the Environment?

During my usual morning "creative convolutions" (actually, while preparing breakfast), I got to thinking a bit more about how we-- as humans; as a society-- deal with those who don't fit the prescribed norm of... normal.

I should preface this by saying that I have never made any secret of the fact that I have a fairly strong dislike for pharmeceutical interventions in people's lives except when it is completely evident and clear that they are inhibited from enjoying a decent quality of life. Even then, I believe pharmaceuticals are best used to create a "bridge of sanity" we can temporarily use while we establish a new way of life that allows us to become function without meds.

Why do I feel this way?

Well, there's a long list... so I'll just stick to a couple of main points.

Here is the west, we tend to "treat" conditions rather than heal people. That is, we throw medication at symptoms to get rid of them, and then pretend that people are "well" because they are now "functional" and yet? Nothing has actually been done to assess and address the underlying causes responsible for the issue.

My biggest issue, however, is that most pharmaceuticals and other courses of treatment are are centered around a rather mechanistic paradigm of "adjusting people to suit their environment," rather than adjusting the environment to suit people.

Think about it, for a moment:

When we decide to medicate Bob, what are we really doing? It's a pretty good bet that the underlying idea is "How can be make Bob 'normal' so he can fit into society?"

Similarly, when we medicate kids with ADHD, what we are (in many-- or most-- cases) really doing is trying to "normalize" them so they will fit into a school system where they get to learn to take "standardized" tests that serve little more purpose than to churn out a bunch of trained monkeys incapable of engaging in independent critical thought. From where I am sitting... there's a disturbing element of disrespect for individuality and differences inherent within such an approach.

Naturally, there's a whole flock of doctors, psychologists and ADHD "experts" ready to crucify me for holding such beliefs... and they will viciously defend themselves.

To be honest, I can't blame doctors as they are the product of a medical and psychological establishment that teaches that "medical success" walks hand in hand with healthy patients being compliant with the defined "norms" of the moment.

It all makes me think of that rather famous quote by thinker and author Jiddu Krishnamurti:

"It is no measure of health to be well adjusted to a profoundly sick society."

Isn't that what we are promoting, here? Or at least some variation thereof?

Again, don't get me wrong-- I believe medications have their place, and they can be part of the solution. But they are not THE solution. And unless I am out there endangering myself or pulling the ears off baby bunnies, am I not better off creating an environment that suits me, rather than trying to shoehorn myself into a box labeled "normal," in order to fit the environment?

Focusing... by UN-focusing

Sometimes, the only way I can hope to stay focused is by remaining UN-focused.

I have a really busy day ahead of me-- there is basically "too much stuff" that needs to be done today, and getting it all done will require a lot of focus.

When you live with ADHD Inattentive, a funny thing happens. Well... at least a funny thing happens to me. When I start really concentrating on something, I can feel my brain start to shut down, within about 5-10 minutes... instead of getting a neurotransmitter "boost" to help me get a lot done, my brain gets the "message" that I clearly haven't slept in five days, and I should take a nap... immediately.

As the outcome of a lot of experimentation over the past 20 years, I have managed to build a semi-functional life around the process of "chunking small." It's not exactly the same interpretation as that term as used in NLP, but it basically means that if I make the discrete tasks I attempt small enough, I can "fool" my brain by being finished with any given task that needs doing, before I get chemical messages to go to sleep.

Lather, rinse, repeat.

I also openly allow "distractions" and-- in fact-- try to work with them to my benefit, rather than making them "bad" and trying to resist them.

For example, looking at today's work load... I can't possibly hope to "list 88 items on eBay," but I might just be able to "list ONE item on eBay," 88 times. Maybe that sounds like the same thing, but I can assure you it is not, when you live inside this body and brain. In the pursuit of today's work, it is also likely that I will "allow" myself to sidetrack, at least 40-50 times... for a minute or two, segueing into some other very small task.

To many an outsider, this probably all sounds like an excuse to put a fancy label on simple procrastination. So be it. Maybe procrastination is the "ugly stepchild" (of sorts) of ADHD.

I am less concerned with "labels" than I am with functional living. And in my world, that means non-pharmaceutical functional living.

I have learned to work with "distractions" as part of a functional routine. I even wrote this article (hand written, on bits of paper) while standing in the kitchen, feeding the dog her breakfast and waiting for my toast to finish toasting. It "works" because it allows my brain to "roam" and stay unfocused, which means I can avoid the dreaded "brain sleep" that invariably seems to accompany any attempts I make to concentrate and focus on something.

Which leaves the question of what I can find to distract myself with, while typing out these words for publication. These words, which started as a "distraction" from something else I was thinking about doing...

ADHD, Discernment and Prioritizing

Over the years, I have learned to use a series of "coping tools" in lieu of letting myself get "drugged into oblivion."

Don't get me wrong, I have nothing against "better living through pharmaceuticals," but I prefer to limit such things to blood pressure meds and the like.

When I sit inside my personal experience with ADHD (and also draw on experiences and anecdotes others have shared), it has always struck me that there is always so much on our plates; so many things clamoring for our attention.

This morning I reflected on "all the things" I need to get done this week, and it occurred to me that one of the defining characteristics of ADHD-- at least for me and for a lot of people-- seems to be a difficulty practicing discernment. It's not really a case of me having "more things" I need to get done, but a case of me having great difficulty prioritizing those things appropriately. That is, all the things that come up feel "equally important," and then I get stuck while contemplating where to begin.

I get the distinct impression that the majority of the world has just as many things they need to get done as I do, but they have a much better ability to look at something, declare it "not important," and then move on with what matters most. I find it quite difficult to "rank" things. And sometimes I rank them "poorly," assigning excess importance to "busy work" that will make it easier for me to deal with the most important things. Which, in turn, leaves those "most important things" UN-done, often causing me all manners of headaches.

Even as I make my way through the day, using my system of "task notes," I find it a struggle to decide which things are most important... and I often end up in a pattern of "cleaning my desk so I can do my work" when I really should just launch directly into "doing my work."

It's all a learning process... but sometimes it feels like I am moving desperately slowly.

"Systems" are good, BUT...

Over the past few years, I have created myself a bunch of "systems" that seem to help me focus more and basically live as a somewhat "functioning human being."

That's of course a "good thing," on the greater scale of things, and I recognize that I have put so much effort into it because I really do not want to become "one of those people" who ends up living their lives functionally only as a result of taking a giant handful of medications and supplements every day. It's bad enough that I've had to accept that I will probably be taking blood pressure meds, for the remainder of my days. I am not sure why-- although my mother being a functional alcoholic might be partially to blame-- but I have always viewed the need for "chemical help" with considerable suspicion and loathing.

Part of that suspicion is also related to my general belief that our society tends to excessively "medicalize" perfectly normal parts of the spectrum of human experience.

"Oooh! He FELT something! Give him a pill..."

I really hate that crap. It's a cop-out, in my opinion. Now, I'm not suggesting that there aren't people who genuinely need medication to function, but I am saying that we tend to just "throw medicine at problems" rather than trying to actually discover and isolate their root causes... and then promote actual healing, rather than ongoing "treatment."

But I'm digressing. Because that's what I do, as a person with ADHD.

The point here was that I have created myself a bunch of "operating systems" (lists, timers, etc.) by which I stay some semblance of functional. However... as effective as those may be in keeping me on an even keel, I sometimes find myself wondering if the 30-45 minutes I now spend every morning "setting up for the day" are really worth it. Has the "system" I've created become more of an encumbrance (and a time-waster) than a help?

Ultimately, I don't think so. I feel helped by my increasingly spotless home office and my system of notes and schedules, and that bears out... in terms of what I can look at and say "I actually accomplished that" at the end of the day. However, it's important that I remain mindful of my tendency to eternally "fine tune" and create "subsystems of subsystems" when all that's really needed is an overall framework.

Mindfulness is essential, when you live with ADHD... because there are "tempting distractions" around every corner; even those "corners" actively designed to help.

Understanding My Own Processes

A friend (who's also a counselor and therapist) recently asked me how I "deal with" ADHD, especially given that I am not using meds or "seeing anyone" about it.

It made me sit down and clarify my "process," and I concluded that I have really been "experimenting" with my life, for some time, now. There are essentially two parts to this "gig" for me... and I recognize that they are probably "peculiar" to someone whose issue is the "primarily inattentive" variant.

One, I have learned to become very mindful of the fine line between what is simply "being an HSP" and "my Myers-Briggs/personality preferences" and what is "a condition." We must know-- and acknowledge-- where we simply are "wired that way" and where we have a "condition" we can actually do something about. But you already know that part, I'm sure.

Two, the most helpful thing I have learned is to live through a process of allowing and working with the ADHD, rather than trying to "combat" or "fight" it. Again, a mindfulness practice is essential to me... that is, being aware of the moments when I start "drifting."

It might be something like "Uh-oh, I'm writing this article and I just had an idea for another article...." So instead of metaphorically "slapping myself" and saying "FOCUS!" I "allow" a one-minute sidetrack to sketch out a few quick notes of the new idea, and then I resume writing the "main thing" I was previously working on.

I manage to at least give the appearance of focusing pretty well by (A) being a ferocious note taker when my mind wanders and (B) having a dozen-odd manila folders by my desk, roughly organized by topic/concept... into which my "loose side notes" get filed immediately.

As I have written previously on these pages, the notes serve the purpose of "pulling the idea out of circulation" (inside my head) so-- in a sense-- I can go back to thinking about the main thing on my mind. In a sense taking notes means I can tell myself that I have "acted on" the sidetack, and committed it to a form of "permanent storage" so I don't have to have swirling thoughts about it in "active memory."

It's basically a technique of functionally "taking away" from the swirling cloud inside my head-- a constant (and quite active) process of simplify, simplify, simplify. Somehow, it is easier for me to deal with the physical mess of all the paper scraps, than the mental mess of trying to track too many ideas in my head. From a purely functional perspective, it also means that I get a lot more done.

Now... I'll bring back up that this process works for me; in general the notions of time, structure and organization flow pretty "naturally" for me. This may not work as well for different personality types.

I have also found that "breaking state" (like going to a different part of the house to do certain tasks) can be quite effective, too. If I can remove myself (physically) from my venues of "easiest distraction" withOUT also removing myself from my creative "power spots" (not always possible) that can really help.

Being a Highly Sensitive Person with ADHD

I am a Highly Sensitive Person (or HSP).

And I am an HSP with ADHD.

Lots of HSPs are afflicted with ADHD, but for several years now I have been pondering the overlaps and connections. Being an HSP is not a "diagnosis," it simply means you have an inborn genetic trait; your body is "hard wired" a certain way. You feel more; you feel more intensely.

The "intersect," as I experience it (and other HSPs have shared very similar experiences with me) is that because being highly sensitive makes me "feel things deeply," I experience the effects of ADHD more "intensely." And sometimes those experiences feel "amplified" to a rather debilitating extent.

It is really important to understand that being an HSP and having ADHD are two distinct situations. One does not CAUSE the other, and one does not IMPLY the other. To the degree there are correlations between the two, they are typically "non-causal."

Stated differently, I am having "the same ADHD experience" as everyone else, but because I am an HSP, how that feels is more intense than most people's feelings.

One of the places I have struggled most is to manage the "limited bandwidth/energy" I often have because I am highly sensitive alongside the general distractability that goes with ADHD. The end result is this "state" in which I feel overwhelmed and overstimulated (the "HSP part") by the fact that my inability to focus (the ADHD part) is keeping me from being able to efficiently navigate daily life.

In a practical sense, it has manifested as periods during which I feel totally immobilized... not by my actual work and chores, but by knowing how much effort it will take simply to stay focused.

It's hard to explain-- and perhaps it doesn't really make sense unless you're also an HSP, yourself. I will of course add in here that my "issue" is the Inattentive form of ADHD (wikipedia), which is quite different from the well-known "Hyperactivity" form most people are familiar with.

I am still trying to make sense of the "intersect" of the two. Here's a metaphor that helps me a little:

I think of myself as a piece of machinery. I have a fuel tank containing a certain amount of fuel. As people, we all have "fuel tanks" of certain sizes. As a Highly Sensitive Person, I burn the available fuel faster than most people. As a result, when I am faced with the consequences of my ADHD, I have less fuel available to "fix things" and simply "keep plugging along," till whatever I needed to do is done. This leads to a "secondary feedback loop" in which I feel overwhelmed because it feels like no matter what, I won't have the fuel reserves to complete what I need to deal with.

Many years ago, I used to think of it as "Bailing out the Titanic with a tea cup." No matter what, the ship would "sink." My efforts were only sufficient to slow down the inevitable sinking.

Hence, a period of years during which I have been trying to "simplify" my life, so the "available fuel" will be sufficient to deal with the "stuff of life"... because there's no "increasing the size of the fuel tank." The answer, continuing with the ship metaphor, isn't to become better at bailing, but to make sure I'm on a smaller ship.

If you are an HSP with ADHD, "simplifying life" may be one of your single best coping tools-- and I also mention that because many HSPs are loath to resort to medications, because of the stronger impact of side effects.