GABOR MAT BOOKS. Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder. and adults living with the problems Attention Deficit Disorder presents. Online PDF Scattered: How Attention Deficit Disorder Originates and What You Do About It Gabor Mate pdf, by Gabor Mate Scattered: How Attention Deficit. —Ivan Illich, Limits To Medicine. Until four years ago I understood attention deficit disorder about as well as the average North American doctor, which is to say.
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Download Read Scattered: How A.D.D. Originates and What You Can Do (Gabor Mate) PDF Ebook Donwload Here bestthing.info An. Scattered: how attention deficit disorder originates and what you can do about it by Gabor Maté; 3 editions; First published in ; Subjects. DOWNLOAD Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder By Gabor Mate [PDF EBOOK EPUB site]. High Voltage.
Topics covered: 1. How to recognize AD H D: symptoms and signs; 2. How the human brain develops in interaction with the environment; 4. Understanding the behaviours of the ADD child and adult; 5. The uses, misuses, dangers and limitations of medications; 6. The use and abuse of medications in treating AD H D; 7. The AD H D student in the classroom; 8. How to promote healthy development at any age. People who do not yet know they have it will have their lives transformed.
My life, as the lives of many adults with ADD, resembled a juggling act from the old Ed Sullivan show: a man spins plates, each balanced on a stick. He keeps adding more and more sticks and plates, running back and forth frantically between them as each stick, increasingly unsteady, threatens to topple over. He could only keep this up for so long before the sticks totter and the plates begin to shatter, or he himself collapses.
Something has to give, but the ADD personality has trouble letting go of anything. Unlike the juggler, he cannot stop the performance. With an impatience and lack of judgement characteristic of ADD I had already begun to self-medicate, even before the formal diagnosis. A sense of urgency typifies attention deficit disorder, a desperation to have immediately whatever it is that one may desire at the moment, be it an object, an activity, or a relationship.
And there was something else here too, well expressed by a woman who some months later came for help. One longs to escape the fatiguing, ever-spinning, ever-churning mind. I took Ritalin in a higher than recommended initial dose on the very day I first heard about attention deficit disorder. Within minutes I felt euphoric and present, experienced myself as full of insight and love. My wife thought I was acting weird.
I was not an undereducated teenager eager for kicks when I self-administered the Ritalin. Already in my fifties, I was a successful and respected family doctor whose columns of medical opinion were praised for their thoughtfulness.
I practice medicine with a high value on avoiding pharmacology unless absolutely necessary and, needless to say, I have always advised patients against self-medicating. Such striking imbalance between intellectual awareness on the one hand and emotional and behavioural self-control on the other is characteristic of people with attention deficit disorder.
This plunge into impulsiveness notwithstanding, I believed there was light at the end of the tunnel. The problem was clear, the remedy elegantly simple: certain parts of my brain were dormant half the time; all that needed to be done was to rouse them from slumber.
It did not work out that way. Nothing much seemed to change in my life. There were new insights, but that which had been good stayed good and that which had been bad stayed bad. The Ritalin soon made me depressed. Dexedrine, the stimulant I was next prescribed, made me more alert and helped me become a more efficient workaholic. It is never that easy.
Since being diagnosed myself, I have seen hundreds of adults and children with attention deficit disorder. I now think that physicians and prescriptions for drugs have come to play a lopsidedly exaggerated role in the treatment of ADD.
What begins as a problem of society and human development has become almost exclusively defined as a medical ailment.
Even if in many cases medications do help, the healing ADD calls for is not a process of recovery from some illness. It does not follow, however, that we can explain all the problems of the ADD mind simply by referring to the biology of out-of-balance neurochemicals and short-circuited neurological pathways.
I now think that physicians and prescriptions for drugs have come to play a lopsidedly exaggerated role in the treatment of ADD. What begins as a problem of society and human development has become almost exclusively defined as a medical ailment.
Even if in many cases medications do help, the healing ADD calls for is not a process of recovery from some illness.
It is a process of becoming whole which, it so happens, is the original sense of the word healing. There is no disputing the malfunctioning neurophysiology in what we call attention deficit disorder. It does not follow, however, that we can explain all the problems of the ADD mind simply by referring to the biology of out-of-balance neurochemicals and short-circuited neurological pathways.
A patient and compassionate inquiry is needed if we are to identify the deeper meanings manifested in the crossed neural signals, troubled behaviours, and psychological tumult which together have been named ADD. My three children also have attention deficit disorder not by my own diagnosis, but according to evaluations at a hospital-based clinic. One has taken medication, with clear benefit, but none are requiring to do so at the present time.
In light of such a strong family history it may seem surprising that I do not believe ADD is the almost purely genetic condition many people assume it to be.
I do not see it as a fixed, inherited brain disorder but as a physiological consequence of life in a particular environment, in a particular culture. In many ways one can grow out it, at any age. The first step is to discard the illness model, along with any notion that medications can offer more than a partial, stop-gap response. A certain fad-like mystique has recently evolved around ADD, but despite what many people think it is not a recently discovered entity.
In one form or another it has been recognized in North America since ; its present pharmacologic treatment with psychostimulants was pioneered over six decades ago.
The names given to it and its exact descriptions have gone through several mutations.
Its current definition is given in the fourth edition of the Diagnostic and Statistical Manual, scripture and encyclopaedia of the American Psychiatric Association. The DSM IV defines attention deficit disorder by its external features, not by its emotional meaning in the lives of individual human beings. It commits the faux pas of calling these external observations symptoms, whereas that word in medical language denotes a patients own felt experience.
External observations, no matter how acute, are signs. A headache is a symptom. A chest sound registered by the doctors stethoscope is a sign.
A cough is both a symptom and a sign. The DSM speaks the language of signs because the world view of conventional medicine is unfamiliar with the language of the heart.
Siegel has said, The DSM is concerned with categories, not with pain. ADD has much to do with pain, present in every one of the adults and children who have come to me for assessment. The deep emotional hurt they carry, each and all, is telegraphed by the downcast, averted eyes, the rapid, meandering flow of speech that seems almost oblivious of the listener, the tense body postures, the tapping feet and fidgety hands, and by the nervous, self- deprecating humour.
Every aspect of my life hurts, a year old man told me in the course of his second visit to my office. People express surprise when after a brief exchange I seem to be able to sense their pain and grasp their confused and conflicted history of emotions. I am speaking about myself, I tell them. At times I have wished that the experts and media pundits who deny the existence of attention deficit disorder could meet only a few of the severely affected adults who have sought my help.
These men and women, in their thirties, forties and fifties, have never been able to maintain any sort of a long term job or profession. They cannot easily enter meaningful, committed 7 relationships, let alone stay in one. Some have never been able to read a book from cover to cover, some cannot even sit through a movie.
Their moods fly back and forth from lethargy and dejection to agitation. The creative talents they have been blessed with have not been pursued, any thoughts of cultivating them abandoned. They are intensely frustrated at what they perceive as their failures. Their self-esteem is lost in some deep well. Most often they are firm in the conviction that their problems are the result of a basic, incorrigible flaw in their personalities.
I would want any doubting Thomases to read and consider the autobiographical sketch submitted to me by John, a fifty-one year old unemployed single man. Shown emotion or I drift off or when I get to do Something cant finish it or start doing Something then eye start Something else. Get a anxous feeling got to do it or else. Seem to mindwonder or daydream. I cant seem to get what people want from me cant understand.
Report cards in school would always have something like doesnt pay Attention in class, doesnt sit still took me longer to Learn or understand. Always was in trouble was stuck sitting in front of class or in back of class or principals office strapped been tied down in chair.
Sent to sit out in hall my dad was always telling me to sit still what lazy bum I am my room. Johns speech is far more articulate than his writing, but not less poignant. My dad, he said, always rubbed my nose in it, that I should have been a doctor or a lawyer, or else I wouldnt amount to anything.
After my parents divorced the only time they would talk to each other was when my mother called my dad to say give him heck. I saw a video last week, he added. Patients are graphic about their feeling states, often almost lyrical. Ah, a forty-seven-year old man said with a discouraged wave of the hand and a smile that was resigned and mischievous at the same time, my life is just so much soup and garbage can. What those words mean exactly, I could not say. Like poetry, they convey their meaning through the feelings and word associations they evoke.
Landed in the soup. Fog as thick as soup. Soup kitchen. Treated like a piece of garbage. I feel like garbage. Images of distress, loneliness and confusion, presented with a tinge of humour. The strangely dissonant imagery tells also of a troubled soul who found reality harsh so harsh that the mind had to be fragmented in order to fragment the pain.
Chapter Two Many Roads Not Travelled To get through each day, natures that are at all high strung, as was mine, are equipped, like motor cars, with different gears. There are mountainous, arduous days, up which one takes an infinite time to climb, and downward-sloping days which one can descend at full tilt, singing as one goes.
Marcel Proust, In Search of Lost Time Attention deficit disorder is defined by three major features, any two of which suffice for the diagnosis: poor attention skills, deficient impulse control, and hyperactivity. The hallmark of ADD is an automatic, unwilled tuning out, a frustrating non-presence of mind. One misses information and directions, misplaces things, and struggles to stay abreast of conversations.
Tuning out creates practical hardships, and it also interferes with ones enjoyment of life. A continuous and whole experience of music is unknown to me, a high school teacher said. My mind is off wondering after only a few chords. It is a major exercise for me even to hear one brief song through on my car radio. There is a sense being cut off from reality, an almost disembodied separation from the physical present.
I feel like I am a human giraffe, is how one man described it, as if my head is floating in a different world, way above my body.
This absence of mind is one cause of the distractibility and short attention spans which bedevil the adult or child with ADD, except around activities of high interest and motivation. There is an almost active not noticing, as if a person purposefully went out of his way to be oblivious of what is around him.
I compliment my wife for a new decoration in our living room, only to be told that the very same item has been in that very same place for months or even years. The distractibility fosters chaos. You decide to clean your room which, typically, looks like a tornado has just passed through. You pick a book off the floor and move to replace it on the shelf. As you do so, you notice that two volumes of poetry by William Carlos Williams are not stacked side by side. Forgetting the debris on the floor, you lift one of the volumes to place it beside its sibling.
Turning a page, you begin to read a poem. The poem has a classical reference in it, which prompts you to consult your guide to Greek mythology; now you are lost because one reference leads to another. An hour later, your interest in classical mythology exhausted for the moment, you return to your intended task. You are hunting for the missing half of a pair of socks which has gone on furlough, perhaps permanently, when another item of clothing on the floor reminds you that you have laundry to wash before the evening.
As you head downstairs, laundry hamper in arm, the telephone rings.
Your plan to create order in your room is now doomed. Completely lacking in the ADD mind is a template for order, a mental model of how order comes about. One may be able to visualize what a tidy and organized room would look like, but the mind-set of how one would get there is missing. To begin with, there is a profound reluctance to discard anything who knows when I may need that copy of The New Yorker which has gathered dust for three years without ever being looked at?
There is little space for anything. You never feel you can master the confused mess of books, papers, magazines, pieces of clothing, compact discs, letters to be answered, and sundry other objects you only shift portions of the chaos from one corner to the next. Should you nevertheless succeed now and then, you know full well that the order is temporary.
Soon you will be throwing things about again, seeking some needed item you are sure you saw recently in some obscure nook or cranny. The law of entropy rules: order is fleeting, chaos is absolute. A relatively few people with ADD have extraordinary mechanical skills and are able to dismantle and assemble complex objects, pieces of machinery and the like, almost intuitively.
Gabor Maté (physician)
Coordination difficulties affect most others, particularly in the area of fine motor control. Things are dropped, feet are stepped on, balls fly in the wrong direction.
Objects piled on top of each other during clean-up are fated to come crashing down. By opening the closet door one precipitates an avalanche of books, clothes, and other items which had been gathered and arranged pell-mell, or simply thrown on top of each other in the hope that they would sort themselves out. Telephone numbers are scribbled with the digits misplaced: even if one can read what one has written, one will still get the number wrong.
Like many others with ADD, I have little ability to form three dimensional mental representations 9 or to divine the spatial relationships of things, no matter how well explained.
When in a novel I come to a physical description of, say, a room with a desk here, a bed there, a window, a night stand, my minds eye just glazes over. I cant configure it in my imagination. Asking for directions in the street, the person with ADD loses track by the time his informant is half-way through her first sentence.
Fortunately, he has perfected the art of nodding. Ashamed to admit his lack of comprehension and knowing the futility of asking for clarifications which he would grasp with no greater success, he gives a masterful impersonation of one who understands. Then he heads off, entrusting himself to good fortune. When there is a fifty per cent possibility of choosing the wrong turn, I will do so about seventy-five per cent of the time, one of my ADD patients said.
The deficient visual-spatial sense works synergistically with the distractibility. Our hapless friend order just doesnt stand a chance. The distractibility in ADD is not consistent. Many parents and teachers are misled: to some activities a child may be able devote, if anything, a compulsive, hyperconcentrated attention. But hyperfocusing which exludes awareness of ones environment is also poor attention regulation. Too, often hyperfocusing involves what may be described as passive attention, as in watching television or playing video games.
Passive attention permits the mind to cruise on automatic without requiring the brain to expend effortful energy. Active attention, in which the mind is fully engaged and the brain has to perform work, is mustered only in special circumstances of high motivation.
Active attention is a capacity the ADD brain lacks whenever organized work must to be done, or when attention needs to be directed towards something of low interest. A facility for focusing when one is interested in something does not rule out ADD, but to be able to focus the person with ADD needs a much higher level of motivation than do other people.
Ignorance of this fact has led many doctors to miss the diagnosis. Indeed, the characteristic of our patient, wrote a psychiatrist of a college lecturer I had diagnosed with attention deficit disorder but whose GP wanted a second opinion, is that he is able to focus his attention on something that he is really interested in, which for patients afflicted with ADD is very difficult.
That is not what is very difficult.
The Origins and Healing of Attention Deficit Disorder
What can be immobilizingly difficult is to arouse the brains motivational apparatus in the absence of personal interest. ADD is situational: in the same individual its expression may vary greatly from one circumstance to another. There are certain classes, for example, in which the ADD child may perform remarkably well, while in others she is scattered, unproductive, and perhaps disruptive. Teachers may conclude that the child is wilfully deciding when, or when not, to buckle down and work diligently.
Many children with ADD are subjected to overt disapproval and public shaming in the classroom for behaviours they do not consciously choose. These children are not purposively inattentive or disobedient.
There are emotional and neurophysiological forces at play that do the actual deciding for them. We shall examine them in due course. The second nearly ubiquitous characteristic of ADD is impulsiveness of word or deed, with poorly-controlled emotional reactivity. The adult or child with ADD can barely restrain himself from interrupting others, finds it a torture awaiting his turn in all manner of activities, and will often act or speak impulsively as if aforethought had never been invented.
The consequences are predictably negative. One is forever trying to shut the barn door after the horse has bolted.
I want to control myself, a year old man said at his first visit to my office, but my mind wont let me. The impulsiveness may express itself as impulse downloading, the download of unneeded items on a sudden whim without regard for cost or consequence.
Impulse downloading? If I had the money I would impulse download the whole world. Hyperactivity is the third salient characteristic of ADD. Classically it is expressed by trouble 10 keeping physically still, but it may also be present in forms not readily obvious to the observer.
Some fidgetiness will likely be apparent toes or fingers tapping, thighs pumping, nails being chewed, teeth biting the inside of the mouth. The hyperactivity may also take the form of excessive talking.
In a minority of cases, especially in girls, hyperactivity may be absent altogether. They may go through school inattentive and absent minded but, as they cause no trouble, they are passed through from grade to grade. While the finding of hyperactivity is not required for the diagnosis of ADD, it can be quite dramatic for some patients. The only thing that ever slowed me down was the police siren when I was caught speeding, said a twenty-seven year old woman.
The loquacious hyperverbality of many children with ADD is notorious. One Grade Two little boy was called talk bird by his classmates, so incessant was his chatter. His parents, too, were often after him to be quiet. Its as if such a child is saying I am cut off from people. My anxiety is that if I dont work overtime to establish contact with them, I will be left alone.
I only know to do this through my words. I know no other way. Some adults with ADD have told me that they speak so quickly in part because so many words and phrases tumble into their minds that they fear forgetting the most important ones unless they release them at a fast rate. The individual with ADD experiences the mind as a perpetual motion machine. I have a mind like a butterfly, a fifty-seven year old woman said. An intense aversion to boredom, an abhorrence of it, seizes hold as soon as there is no ready focus of activity, distraction, or attention.
One experiences an unremitting lack of stillness internally a constant background static in the brain, a ceaseless white noise, as Harvard psychiatrist Dr. John Ratey has put it. There is a merciless pressure in ones mind impelling one on, without necessarily any specific aim or direction.
As long ago as an article in The New England Journal of Medicine identified a distressing driven quality to some peoples lives, which the authors called organic drivenness.
I, for one, have rarely had a moments relaxation without the immediate and troubling feeling that I ought to be doing something else instead. Like father like son. At the age of eight or nine my son said to me once that I always think I should be doing something but I dont know what it is. The oldest person to whom I have prescribed a stimulant was an eighty- five year old woman who, on taking Ritalin, was able to sit still more than fifteen minutes for what was literally the very first time in her life.
The restlessness coexists with long periods of procrastination. The threat of failure or the promise of reward has to be immediate for the motivation apparatus to be turned on. Without the rousing adrenalin rush of racing against time inertia prevails.
Not once in high-school or university did I begin an assignment or essay before the eve of the day it was due. In that era of manual typewriters my rough copies had to serve simultaneously as final copies. They resembled academic tossed salad: sheet upon sheet pasted over by pieces of paper with hastily scribbled corrections. On the other hand, when there is something one wants neither patience nor procrastination exist.
One has to do it, get it, have it, experience it, immediately. Frequent and frustrating memory lapses punctuate every day in the life of the person with ADD. A close friend of mine, Brian, has attention deficit disorder.
He also has a dog. They take each other for walks every day. As Brian puts on his coat, hat, and boots the dog lies under the kitchen table, waiting. Brian leaves the house, the dog doesnt move. The dog will not move until Brian has come back into the house for the third time for key, wallet, or whatever other items he has forgotten to take the first two times.You will also find hope.
In light of such a strong family history it may seem surprising that I do not believe ADD is the almost purely genetic condition many people assume it to be. Vancouver Sun [Mat] challenges the standard view of ADD [and] asks questions that deserve to be considered about a debilitating disorder and the kind of society in which is flourishes. It has been a very validating book to read. Although some ADD children shrink away from being touched, in early childhood most of them literally climb all over adults and generally exhibit an almost insatiable desire for physical and emotional contact.
I would enthusiastically recommend Scattered to anyone touched by ADD adults, parents, and professionals. I have an anxiety that you dont want me around you, the child is really saying, and, when I am anxious I do not know how to be on my own.
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