Book Review: Scattered Minds by Gabor Maté


The Origins and Healing of ADD

*** 3/3 ***

The first time I met the Mistress who is accepting my submission, she suggested that I read Gabor Mate’s book on ADD.  We had been talking about emotions, and I was relating to her how coping with my emotions—mainly their strength and how suppressing them was a protection mechanism—had been one of the challenges of my adult life–but that also expressing them was turning out to be one of the joys.

I bought the book.  Having been formally diagnosed as a child, and medicated for it, I still refused to acknowledge that I was indeed ADD.  This book helped me accept it, understand it, and come to terms with it.  It is a fantastic book and looks at the topic from a fresh angle.

I see so much of myself in here Mistress.  I can’t thank you enough for leading me to it.  I recognise that the burden of change lies on my shoulders and promise that I will not rely on you for my personal growth but will work tirelessly to learn from this and apply it to my life.  You are not my therapist, but your contribution to my healing and growth is very real and important.  Thank you from the bottom of my heart.

This is a lengthy review, with some of the messages I found highlighted. It is so long because the book is that good.  They follow the sequence of chapters in the book.

Chapter 1

  • ADD is described as the result of “bad genes” by the believers and “bad parenting” by those who do not.  [This would be my parent’s accusatory interpretations of one another’s contributions to our domestic life!]
  • A sense of urgency typifies ADD, a desperation to have whatever it is now
  • Healing from ADD is a process of becoming whole
  • ADD has much to do with pain, emotional hurt
  • ADD is defined by 3 major features: poor attention skills, deficient impulse control, and hyperactivity
  • Active “not noticing”…your wife could wear something for years and then you notice it for the first time
  • Lacking in the ADD mind is a template for order
  • Profound reluctance to discard anything
  • Distraction can be misleading because it can also pair with hyper focus, but in reality both are symptoms of poor attention to the surrounding environment
  • Active attention, when the mind is fully engaged and performing work is only mastered when motivation is high.  Active attention is a capacity the ADD brain lacks whenever organized work must be done, or when attention needs a much higher level of motivation than for other people
  • ADD children struggle to wait their turn, frequently interrupting
  • Impulse buying
  • Loquaciousness
  • ADD people struggle to relax, and have an immediate and troubling feeling that they ought to be doing something else
  • The threat of failure or the promise of reward has to be immediate for the motivation apparatus to be turned on
  • Forget keys, wallet, whatever, over and over
  • An ADD adult looks back on his life as countless plans never fully realized and intentions unfulfilled.
  • Some ADD children shrink from being touched, but most are the opposite
  • ADD adults may be perceived as aloof or arrogant or tiresomely talkative or boorish
  • People with ADD have about them a palpable intensity that other people respond to with unease and instinctive withdrawal
  • ADD kids often act the class clown
  • Rapid, unpredictable mood swings
  • The common theme on all days, good or bad, is a gnawing sense of having missed out on something important in life.

Chapter 4

  • A feeling of duty towards the whole world, often at the expense of those closest is typical of ADD

Chapter 5

  • I do not wish to be late.  I do not think I will be late.  If I have to be somewhere at 9 and it is not yet 9, I still believe I can make it.  The ADD mind is afflicted by a time illiteracy, a time blindness
  • ADD people “forget to remember the future”…the short terms goals are chosen over the long term…and have a childish inability to think of the consequences
  • Common thread…lack of self-regulation…Distractability, hyperactivity, poor impulse control
  • Underdevelopment of Emotional Intelligence: EQ means you can moderate yourself and persist in the face of frustrations, to control impulse and delay gratification, to regulate moods…ADD is the “not” being able to…
  • The brain centres where the deepest emotions of fear or rage are generated simply overwhelm the higher centres meant to govern them: “so and so is behaving like a baby” is quite literally what is going on
  • ADD is a problem of development rather than one of pathology
  • Ask…what conditions inhibit physiological and psychological motivation…why a self-motivated, self-regulated personality does not have these issues

Chapter 6

  • Pregnancies under severe stress…eg. Pre-divorce.  Stress hormones influence the unborn child
  • The environment that most profoundly shapes human personality is the invisible one: the emotional atmosphere of a child’s first years
  • A hidden factor of great importance for the child is the parent’s unconscious attitude…in what the child represents for the parents…[in my case—save the marriage—or—“I wish you were a girl”]…the needs that parents have that they subliminally hope the child will meet

Chapter 7–Sensitivity

  • Sensitive is the key operating word with ADD.  ADD people are open to or acutely affected by external stimuli or mental impressions, are clearly affected or emotionally hurt, and are responsive to small changes in the environment
  • ADD is caused by the impact of the environment on particularly sensitive infants
  • People with ADD have “emotional allergies”
  • ADD people are touchy, thin-skinned, too sensitive or touchy
  • Sensitivity is what is being transmitted from parent to child, not ADD.  “The existence of sensitivity is an advantage for humankind because it is this group that best experiences humanity’s creative urges and needs.  Through their instinctual response, the world is interpreted.”

Chapter 8

  • Healthy growth is defined by the matrix of the womb, the most perfect growth environment: nutrition, physical security, unbroken relationship with a safe, maternal, nurturing organism
  • The womb is mother…and she remains so, even following birth

Chapter 9—Attunement and Attachment

  • Attention and self-regulation are areas of the pre-frontal cortex which develop through interaction with the mothering figure
  • ADD originates in stresses that affect the “mothering” of an infant
  • Gaze, tone of voice, body language in the first months are what the infant picks up on
  • Maternal depression is associated with diminished infant attention spans
  • Attunement: the mother and child react to each other…emotional stress on the mother interferes with attunement contact
  • Rapturous mutual gaze
  • Babies read feelings clearly.  In attunement, it is the baby who leads and the mother who follows.  The ADD child’s difficulty reading social cues may originate from their own attunement cues not being read by a nurturing adult

Chapter 10

  • Damage to the pre-frontal cortex produces symptoms similar to ADD…they might need help to finish a line of thought
  • Struggle to learn from experience
  • Easily distracted
  • Changes subjects in conversation
  • Emotional outbursts
  • Lose track of instructions or task

Chapter 12

  • It isn’t divorce per se that is emotionally wearying for the child, it is the long-term tensions and emotional heaviness that precede it
  • Moving a lot in their childhoods, different schools, different towns, no stability of domicile, school, or friendships, plus a non-violent, but forbiddingly stern, angry father is often mentioned

Chapter 13

  • ADD diagnoses are high in North America because of the gradual destruction of the family unit from economic and social pressures.  “The erosion of community, the breakdown of the extended family, the pressures on marriage relationships, the harried lives of nuclear families still intact and the growing sense of insecurity even in. the midst of relative wealth have all combined to create an emotional milieu in which calm, attuned parenting is becoming alarmingly difficult.  The result is successive generations of children seen in alienation, drug use and violence, the ‘rage of the unparented’.”
  • “Family meals, talks, reading together no longer take place.  What the young need—stability, presence, attention, advice, good psychic food, unpolluted stories—is exactly what the ‘sibling society’ won’t give them.
  • The unequal division of emotional work is a major cause of depression in women, and is therefore an important negative influence on the developing brain or the young child
  • It is the recognition by society at large that there is no more important task in the world than the nurturing of the young during the earliest years [from a financial view alone, so much costly social dysfunction could be prevented, but this will not come about unless women’s work in the home is recognised, is added to our calculus of GDP, and stay at home Dad’s are as prevalent as stay at home Moms].
  • There would be far fewer disorders, ADD and others, if parents of both sexes were encouraged to consider the child’s interests paramount in the formative years.

Chapter 14

  • Dissociation is a psychological anaesthetic; it separates conscious awareness from some emotional pain we have experienced.
  • This only works when the distress is severe, ie., trauma and its memory are more harmful to the person’s survival from dealing with it.  The second condition for dissociation is a feeling of helplessness.
  • For an ADD child, there was hurt that required tuning out, which was combined with a feeling of helplessness [in my own life I can remember this…terrifying dreams from which I would wake up screaming for comfort, and no one would come]
  • Many ADD people note a strange drowsiness comes over them in the midst of some emotionally charged situations
  • Unbalanced chemical states, such as blood sugar levels either higher or lower than normal, have a notoriously negative influence on an ADD child
  • ADD kids are “disruptive” in class because they focus on getting their relationship needs met over following the teacher’s lead
  • Nagging hunger for attention (emotional contact) explains the paradox that an ADD child can work and stay focussed when an adult just sits with them
  • When the hurt is deep, the internal world may offer more meaning than the real one…in daydreaming of a better place
  • The warmth and satisfaction of positive contact with the parent. Is often just as good a psychostimulant as dopamine

Chapter 15

  • ‘I’m sorry’ is the most common phrase in the vocabulary of ADD…ADD people apologize a lot

Chapter 16

  • ADD is not something that can be cured, it is something that one can grow out of
  • All the behaviours and mental patterns of ADD are external signs of the wound, or inefficient defences against feeling the pain of it.  Growth can only come when the self does not need to self-protect and has the space to grow.
  • Unconditional Positive Regard.  To create in the child’s heart of hearts for the certainty that she is personally the person the parents want and love
  • You have to be able to bring your least likeable side to the parent without fear that it would threaten the relationship
  • “Time-outs” harm attachment.  They say you can have my attention taken away if you misbehave.  Conflicts between people do not have to end in estrangement.
  • Address the deed, not the child, by displaying “warm anger”

Chapter 18

  • Add people are very sensitive to the external environment, to social changes…reacting automatically instead of purposefully…some ADD people can’t handle change or transition for this reason.  Others with ADD thrive with constant turmoil and change…both of which are a failure of internal regulation
  • When a child shows a hint of his vulnerability instead of defences, the parent needs to establish warm, positive contact
  • The truly strong person need not be so afraid that she has to control the environment but learn to let go.  Manipulation.

Chapter 20

  • ADD kids behave in ways that elicit parental disapproval or attempts at control.  Disapproval increases insecurity and acting out and the parent’s controlling impulses deepen the child’s automatic resistance.
  • ADD kids are all or nothing.  When anger arises, all feelings of attachment and love are banished

Chapter 22

  • All ADD children are unmotivated.  They show a lack of inner-directed purpose.
  • Without the safety of the attachment relationship the child will be anxious to focus his attention on a meaningful exploration of the world around him
  • As attachment security improves so too will competence, and a growing ability to function independently
  • If parents focus on attachment and autonomy, the child will learn about consequences of not meeting obligations (like homework) from the security of that primary relationship
  • Without parental empathy, the child shuts down and hides behind the wall of emotional defences, without structure, he becomes lost, uncertain and anxious

Chapter 23

  • To teach an ADD child, the relationship is the most important thing [certainly true of my own teachers growing up, and also why I so often tried to please my female teachers—to be teacher’s pet]

Chapter 24

  • Teenage defiance is deceptive.  What they need and want is love
  • ADD children have a deep feeling of being misunderstood deeper than they realize.  Criticism, being judged, trigger shame, resistance, and emotional shutdown
  • Offputting teen behaviour is a mask

Chapter 25

  • Consciously harsh self-judgement is a hallmark of low self-esteem.  The ADD person can have a deep dissatisfaction with the self.  The dismissal of their own talents as easy, because they think “if it comes easy it isn’t talent”.  Instead, the ADD person often values the things they “suck at” because those are things that I think my parent wanted for me to be good at, eg. Be a lawyer, a doctor, etc
  • ADD people often suppress their own own feelings in preference to those of others as second nature
  • When we forget how to say no, we surrender our self-esteem

Chapter 26

  • ADD can come with a painful hyperconsciousness of injustice paired with ineffective rage or shamed silence.  The resulting feelings of impotence in the face of events can be literally sickening
  • Empathy also means identification.  ADD people sometimes go from empathy to feeling things directly, ie. It isn’t happening to someone else…I feel it as if it is happening to me.  This is a state of memory.
  • The goal for the ADD adult is to move from the helplessness of identity to the empowered state of empathy
  • Around authority figures, bosses, doctors, police, the ADD adult may experience a nervousness and lack of confidence that cannot be explained by the actual power relationship that exists…becoming once again a child facing powerful adults

Chapter 27

  • Fear of intimacy is universal among ADD adults.  It coexists with a desperate craving for affection and a dread of being rejected.  Healing comes in mutually committed loving contact with another human being.
  • Fear of rejection is one of the most powerful ADD traits…it is never far below the surface.  ADD people are very tuned to the merest hint of it, and it is very easily triggered
  • Defensive attachment…withdrawal dynamics.  “It is so hurtful for me to experience your absence that I will encase myself in a shell of hard emotion, impervious to love…and therefore also pain.”
  • ADD adults find it difficult to trust in relationships, to make themselves truly open and vulnerable.  Depending on the degree of early sorrow, the very idea of commitment may make them anxious. Keeping an eye on the exits…
  • The fear of intimacy is a fear of the loss of self.  The person with ADD craves real human contact, feels like an outsider and wishes to belong, but at the same time is reclusive, preferring his own company to that of others.  The paradox comes from oscillating between two fears: the anxiety of loneliness and abandonment, and opposing that, a parallel sense of danger that if he commits to a relationship, he will be overwhelmed, swallowed up.
  • The unresolved problem is how to be oneself in contact with other people
  • ADD couples often have no sex life: the lack of sexual intimacy is in most cases a sign of mutual emotional shutdown.  ADD males behave like children and wife feels motherly, not just wifely, not sexy, but scolding and nagging, and the ADD male responds by resisting the control, creating a negative spiral.
  • Strength is an inner quality; power is a matter of relationship
  • The feeling of the moment dominates the memory, “historical memory”, ie, you can just forget what you felt before.  The ADD mind shuts out what can’t be there now…it is all or nothing.

Chapter 28—How to Outgrow ADD

  • Shred the defenses.  Become self-aware.  Notice when your behaviour is not aligned with your goals. Guilt is a feeling ADD people can’t stand.  Being a “people pleaser” comes with it…learn to live with it.
  • ADD adults need to find a parent substitute…a trained psychotherapist

“When a person is encouraged to get in touch with and express his deepest feelings in the secure knowledge that he will not be rejected, criticized, nor expected to be different, some kind of rearrangement or sorting out process often occurs within the mind which brings with it a sense of peace.  That the depths of the well of truth have been reached.”

Dr. Anthony STorr

Chapter 29—Other Steps to take

  • The physical space can either help or hurt ADD people…don’t be task focussed, instead time box when an activity will be done…keep the space clean, neat and tidy
  • Sleep hygiene: don’t be a night owl.  The ADD adult dreads going to bed.  They stay up until they collapse so as not to be left with their thoughts [I can thank a previous Mistress for introducing an early bed time to me—and have found it extremely beneficial]
  • Nutrition: focus on managing your blood sugar
  • Physical exercise is important, especially cardio.  ADD people also tend to be particularly stiff, so stretching is important
  • Be in nature, it is very soothing for the ADD person
  • Cut back on extracurricular activities.  Let things go.
  • Recreation should be chosen as it also nourishes the mind
  • Creative expression is very therapeutic [this is why I write]
  • Spirituality…meditation and mindfulness are very helpful to the ADD person
  • Finding a physical connection is an important part of that
  • ADD adults…give yourself time each day for contemplative solitude
  • You cannot force yourself to be motivated, just have compassionate patience towards yourself

Chapter 30

  • ADD people are 3x more likely to smoke.  Nicotine increases alertness and mental efficiency.  It stimulates dopamine and endorphins.
  • ADD people are often addictive shoppers
  • The “pain” that an ADD person seeks to avoid are lower dopamine levels
  • “There is no path towards oneself that leads away from the pain”

Chapter 32

“I have spent my whole life trying to be normal”

Gabor Maté, Recounting the words of one of his Patients
  • Conformism is less painful than being different.  ADD people waste energy trying to be the same when they would get more validation if they just accepted their own difference

I selected the points in this book that spoke to me.  If you, or someone close to you, has ADD or you suspect they might, this book is a must read.  It has and is changing my life for the better.

16 thoughts

  1. I’d really like Mr. Mate (or another relevant specialist/author) to pen a book on high-scoring adverse childhood experience trauma resulting from a highly sensitive and low self-confidence existence, especially when its effect is amplified by an accompanying autism spectrum disorder.

    This, of course, can readily lead to an adulthood of various forms of hazardous self-medicating. As a highly sensitive child, teenager and adult with ASD compounded by a high ACE score, I largely learned this for myself throughout my adult life. It’s what I consider to be a perfect-storm condition with which I greatly struggled yet of which I was not aware until I was a half-century old.

    If one has diagnosed and treated such a condition when very young, I believe he/she will be much better able to deal with the scourge throughout their life.

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    1. This is interesting. You would think that the topic would be written about, and given the high sensitivity from ASD combined with ACE, the impact would be magnified. It is wonderful that you know it now, as at least understanding is the birthplace of healing.

      Liked by 1 person

      1. Yes, one would think so. Maybe some day, though.

        Since so much of our lifelong health comes from our childhood experiences, childhood mental health-care should generate as much societal concern and government funding as does physical health, even though psychological illness/dysfunction typically is not immediately visually observable. After all, a psychologically and emotionally sound (as well as a physically healthy) future should be every child’s foremost right, especially considering the very troubled world into which they never asked to enter.
        ____

        “The way a society functions is a reflection of the childrearing practices of that society. Today we reap what we have sown. Despite the well-documented critical nature of early life experiences, we dedicate few resources to this time of life. We do not educate our children about child development, parenting, or the impact of neglect and trauma on children.” (Dr. Bruce D. Perry, Ph.D. & Dr. John Marcellus)
        _____

        “It has been said that if child abuse and neglect were to disappear today, the Diagnostic and Statistical Manual would shrink to the size of a pamphlet in two generations, and the prisons would empty. Or, as Bernie Siegel, MD, puts it, quite simply, after half a century of practicing medicine, ‘I have become convinced that our number-one public health problem is our childhood’.” (Childhood Disrupted, pg.228).

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  2. Thank you for sharing this resource and your notes, my friend! I was unfamiliar with this book but will plan to add it to my unending list of books to continue my education. I am glad to hear that it has been so helpful in your own journey of self-discovery. XOXO

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  3. Thank you fgsjr2015…your comments are super, well-received, and well-conceived, and so true. I would love to see the world focus on child development, as I agree that getting it wrong in those early years is a big part of what afflicts us today…and it seems such a genuinely fixable problem.

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