Scattered Minds is a book by Gabor Mate about ADHD. It’s about 368 pages long with 7 parts and 32 chapters. In this book review I’ll write my notes down and give a short conclusion at the end.
P1 the nature of ADHD
1 🥫
2
1st characteristic is (distractibility) automatic tuning-out, a frustrating non-presence of mind
- short attention spans except around areas of high interest and motivation
- distractibility fosters chaos
- hyperfocus (compulsive, hyper-concentrated attention)
- passive attention vs active attention 🧠
2nd is impulsiveness of word/deed with poorly controlled emotional reactivity
- impulse buying
3rd is hyperactivity
- fidgeting
- excessive talking
The individual with ADD experiences the mind as a perpetual-motion machine
“white noise” – Dr. John Ratey
- restlessness 🔥 + long periods of procrastination 🦥
- countless plans never realized + intentions unfulfilled
- the common theme is a sense of having missed out on something important in life
3
4
- environment vs genetics
- weekend despair
5
- time blindness
- infant/toddler mode dominant in ADD reflects incomplete development of pathways in the cerebral cortex, between the cortex and lower areas of the brain.
- functions of right prefrontal cortex include impulse control, social-emotional intelligence + motivation 🧠
- EEG (electro-encephalograms) ⚡showed activity in cerebral cortex slowed down when its required to speed up (excessive “slow wave” activity during directed tasks like reading/drawing for ADD group)
- one of its major tasks is inhibition
- our initial response to a stimulus is unconscious, and comes from lower brain centers where emotions originate
- one way to understand ADD neurologically is a lack of inhibition, which means the brain is flooded with multiple bits of sensory data etc.
- thus efficacy of stimulant medications which arouse the inhibitory function (wake up the traffic cop 👮)
- seeing that ADD is a developmental problem, not pathology 👍
p2 how the brain develops
6
- genes can be activated or turned off by factors in the environment (Cree of northwestern Ontario)
- stress hormone cortisol (cortisone) directly affects the developing nervous system
- patterns of reactivity – Greenspan, The Growth of the Mind (1997)
7
- sensitivity from Latin sensir (to feel)
- hypersensitivity
- infants with a higher baseline “tone” in vagus nerve (connects nervous system with heart/lungs/stomach) were more emotionally reactive (University of Washington, Seattle)
8
- brains has between 50-100b nerve cells with total number of connections/synapses in the trillions 🧠
- grows 4x larger outside the womb
- 3 conditions
- nutrition, physically secure environment and unbroken relationship with safe, ever-present maternal organism
9
“Embryologically and anatomically the eye is an extension of the brain; it is almost as if a portion of the brain were in plain sight” – Scientific American
attunement – sharing of emotional spaces 😊
^ quintessential component of a larger process – attachment (being close to somebody)
10
- orbitofrontal cortex (OFC)
- disturbances of OFC are implicated in impulse inhibition/emotional self-regulation
- visual-spatial orientation
- explicit meaning of words spoken is analyzed in left brain
- right OFC interprets emotional content of communications
- Hebb – neurons that fire together wire together
- attunement deficit disorder
p3 roots of ADD in family + society
12
- parents of ADD children report fewer contacts with extended families
13
- Hallowell and Ratey guess that Americans have ADD more often (Driven to Distraction)
- hunter (ADD) gatherer (non-ADD) theory
p4 meaning of ADD traits
14
- mental absence aka dissociation aka tuning out
- being attentive is a skill we acquire
- ADD-drowsiness (yawning) during emotional situations might be due to right prefrontal cortex over-inhibiting reticular formation (network of neurons in brain), an important part of arousal circuity , as emotions are threatening
- over-arousal due to activity of brain 🧠 center where emotions are generated
- once amygdala activates, it magnifies arousal + floods cortex cells with messages of danger
- emotion remains the basis of attention 🌸
- for people deeply hurt, the internal world may offer more meaning than the real one
15
- voluntary nervous system
- autonomic nervous system (ANS)
- sympathetic (expend energy) + parasympathetic (conserve energy)
- hyperactivity – unregulated high arousal
- from 11-17 months, the average toddler gets a prohibition every 9 minutes
- shame begins as a physiological state that escaped regulation by the cortex
p5 the ADD child and healing
16 – it ain’t over till it’s over
- plasticity – responsiveness of brains to changing conditions
- On Becoming a Perosn (Carl Rogers)
- unconditional positive regard (not possessive)
17
18
- emotional self regulation
- individuation / differentiation – becoming a self-motvating person
19
- socioeconomic trends increase the attention starvation of children (EPI USA, average work year is 158 hours longer than 3 decades ago).
20 oppositionality
- counterwill 💨 – resistance put up by a human being with incomplete sense of self
21, 22, 23, 24 (teenagers)
p6 the ADD adult
25 self-esteem
- self-judgement reflects low self-esteem (not low achievement)
- contingent self esteem (based on achievement) ⭐ vs true self esteem
26
- identification vs empathy
- implicit memory system (emotional memory)
- brain has multiple memory systems (Joseph LeDoux)
- explicit memories
27
- fear of intimacy ≡ fear of loss of self
- orbitofrontal cortex (OFC) helps with emotional self-regulation e.g. fear 😨 and fear’s offspring (anxiety) generated in amygdala + other levels below cortex
28
29
- meditation
30
- all addictions are anesthetics – they separate us from distress in our consciousness
- spending $8k 💸 on CDs in a week
p7 conclusion
31 medications
- psychostimulants – methylphenidate (Ritalin), dextroamphetamine suflate (Dexedrine)
- stimulate cerebral cortex by balancing levels of neurotransmitters in the frontal lobe of the brain
32
Conclusion
I give this book 4/5 stars ⭐⭐⭐⭐. It’s well written and contains both physical and psychological theories and examples of how ADD brains function. Maté takes a curious approach to understanding the circumstances of how ADD develops; it can be argued that the rise of ADD in North America can be partially attributed to socioeconomic factors (longer work week). One downside of the book is that it’s kind of long.
I would recommend this book to anybody seeking to understand how ADD works.
Additional reading
Driven to distraction
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