The Troubles of a Name

Tweets and TikToks abound of “You have ADHD if…” followed by some set of symptoms, humorous, serious, and everything in between.

As a practicing psychiatrist, I’ve watch the term “ADHD” coopted by forces of social redefinition over these last few years.

Much of the attention has been quite important and helpful. Awareness and recognition often are.

However, some of it is off-putting. As the term grows, it inevitably loses some of its definition. My concern is less about its gathering new meanings and more that it continues to carry a medical weight as it does so.

The trouble is not in society, as if we were collectively irresponsible.

The trouble is that of any name. Names obscure as much as they reveal.

Once something is named, particularly with some medical acronym, we believe that there is a central thing. We poke and prod and say, “here it is!”, then discover some overlap elsewhere and again say, “no wait, here it is!” and on and on.

But it is we, as humans, who have named it. The medical school joke is that our troubles, ailments, and illnesses don’t read textbooks.

Many Paths

Our signs and symptoms are most likely the crossroads of many paths…

We can get lost in a discussion of biology vs psychology, but neither matters nearly as much as we think. One is a plant and the other a garden. They are hardly separable.

Whether from: anxiety, struggles of focus, difficulties of motivation, fears of the interpersonal, deep but unreliable hyper-focus, impulsivity, alterations to dopaminergic pathways, default mode networks, task positive networks, and more…

… the paths to these similar difficulties are many.

All Who Wander…

Rather than get lost in such a term, I’d prefer to acknowledge the multiplicity of rivers to and from…

… the wistful creative…

… the deeply inquisitive…

… the difficult life…

… the wanderer…

While medical terms have their place, a “Wandering Mind” not only sheds the medical baggage, but it is so much more inclusive and gives us common ground.

Those with a particular diagnosis may be emblematic of a mind that wanders more than most, but everyone’s mind wanders.

It’s just that some wander more than others, even at times of day more than others–sometimes after a traumatic event–sometimes seemingly for no reason at all.

And of course, not all who wander are lost.

The Power of A Wandering Mind

Even more importantly, there is often a clear power that lurks within. Those deep and blossoming moments of creative verdant vitality tell us so. We can strive for those wondrous sessions when the world slips away, the inner critic grows quiet, and a sense of meaning blooms as we dive into something that feels like it matters.

So of course the question follows, can we guide those moments? Can we invite them and even do so responsibly?

Some do and wander with wisdom and calm. Others do not, and fret with agitation.

A Commonality

There is one commonality I often find in those agitated:

an injured sense of agency.

How often have you said, “I know it’s important to do that thing, but I just can’t bring myself to do it”?

That part of ourselves that would allow us to make clear and non-reactive decisions is hurt. By receiving repeated reprimands, in worrying that we’re falling apart, when struggling to simply get up off the couch, we often yell at ourselves in some vain attempt to make our way forward.

In doing so, we harm a vital trust in ourselves. But without knowing any other way, we can only double down creating a vicious cycle.

This is the angle from which we can help a wandering mind, not to stop wandering, but to learn to do so responsibly, with courage and conviction.

We need to be able to:
1. Honor our Past Self who asks us for something,
2. Care for our Future Self who one day we will become, and
3. Respect our Current Self and how we feel now.

When these align, we can guide our waves of focus and engage with deliberate depth.

  • Kourosh Dini

PS. Check out the upcoming“>Waves of Focus 3: Guiding a Wandering Mind