@alice @autistics Another thing that leads me to take a second look at formal diagnosis of #autism is that the recognized experts on #ADHD โ€” #Barkley, #Hallowell, #Ratey โ€” appear to be spectacularly clueless about autism. And I absolutely DO want formal diagnosis of my ADHD, since it's the only way to get optimal treatment for it. But I now suspect that ADHD diagnosticians won't be able even to begin to understand me unless they're also autism diagnosticians, and think of my issue clearly as #AuDHD.
@pathfinder @autistics It's even worse than that. Neither #Hallowell nor #Ratey is exactly neurotypical. Both of them have #ADHD themselves โ€” but they are NOT #autistic. If anything, I suspect their particular form of neurodivergence actually makes it HARDER for them to understand ours. This is a large part of why I'm becoming ever more convinced that #AuDHD is a fundamentally different phenomenon from standalone #ADHD (without autism). Full of benevolence, they offer us their elixir of life, not realizing that to us it is toxic green slime.

I've returned safely from a virtual diorama of #extravert hell โ€” otherwise known as Chapter 4 of "ADHD 2.0" (#Hallowell and #Ratey 2021). Its title is "The Healing Power of Connection", and it's even worse than that title makes it sound to #introvert ears. I had already decried the #extranormativity of this book, but at least before it was merely implied. In Chapter 4, they announce it openly:

"Create ... for yourself ... a connected life. It is the key to pretty much everything good in life. ... A deeply, variously connected life is the most enriching gift you can give yourself and your family."

"It's wonderful to introduce children to people from out of town, even from out of the country, and make dinner a big deal where people meet to eat and greet."

"Engage in some kind of spiritual practice ..."

"Visit graveyards ..."

"Learn about your ancestors."

"... talk to non-related old people about their lives, in detail."

"Be on the lookout for any charismatic mentor."

๐Ÿ˜ฑ ๐Ÿคฏ ๐Ÿ˜ตโ€๐Ÿ’ซ ๐Ÿคข ๐Ÿคฎ

To me, all of this conjures up images of jungle vines extending tendrils to wrap and bind me (Quick, my machete!); of the Borg extending assimilation tubules to transform me into one of their own number; of green slime from "Doctor Who" invading my tissues in an effort to turn me into more of itself.

No doubt Hallowell and Ratey mean well. Then again, I'm sure the Borg must think assimilation is the most priceless gift they can give anyone.

Much of my life has been a struggle to DISCONNECT myself from a culture which, although I was born into it, I perceived from the first as alien, and which did its best to indoctrinate me into its vile ideologies, especially those of a "spiritual" nature โ€” and despite my discomfort, came frighteningly close to succeeding in that effort. (I do, however, appreciate my wife's inquiries into my ancestors; among other things, she was able to demonstrate unequivocally that they had owned slaves, contrary to what I had been told.)

Hallowell and Ratey can KEEP their "connection".

@autistics

@autistics Until I read "ADHD 2.0", I would not have expected that #ADHD would predispose someone to #depression; still less, that the concomitant presence of ADHD would be an indication for a different approach to treating depression than the #CBT used in neurotypicals. But now that #Hallowell and #Ratey have drawn my attention to these issues, their story about the relationship between ADHD and depression makes perfect sense. The book is worth reading for that insight alone, despite the other problems with it that I've pointed out.

(2/2)

I've now finished Chapter 2 of "ADHD 2.0" (#Hallowell and #Ratey 2021). I've had some hard things to say about this book so far: its #extranormativity, its tone of pontificating certainty, its overconfident reliance on dubious #fMRI findings, the appalling glimpse of support for #ABA in a skimmed later chapter. But in the second half of Chapter 2, I've found something really interesting and potentially helpful, something that rings true from my experience, quite apart from any #fMRI findings.

The authors point out a way that #anxiety and #depression can arise purely from the #attentional-focus problems definitive of #ADHD, and NOT from the cognitive errors to which #CBT attributes such problems. The idea is that the obsessiveness of #ADHD, when focused on anything negative, creates a self-sustaining, self-amplifying vortex of negativity. Their description makes it sound almost like a bad trip on #psychedelics. The solution is NOT to try to debunk the negative thoughts that make up the vortex, #CBT-style; indeed, that approach might make things worse by reinforcing the focus on the negative thoughts. Instead, try to refocus on โ€” indeed, obsess about! โ€” something positive instead.

Indeed, #anxiety and (especially) #depression were my own psychiatric diagnoses (not counting bipolar disorder, which later psychiatrists rejected decisively as a misdiagnosis). #CBT was worse than useless. Instead, I got help from antidepressant drugs โ€” and I don't think it was an accident that the best one for me turned out to be Wellbutrin (bupropion), which doubles as a third-line #ADHD drug. And the subjective experience of depression, and of recovery from it, matched Hallowell and Ratey's attentional account, rather than the error-correcting story #CBT tells. I suspect that if there were such a thing as "attentional psychotherapy", I might have benefited from getting that instead of #CBT.

(1/2)

@autistics

I'm now starting Chapter 2 of "ADHD 2.0" (#Hallowell and #Ratey 2021). This is the one where they introduce the supposed neurological underpinnings of #ADHD. I'm noticing a jarring contrast of tone between this book and the autism literature I've read so far, such as Wenn #Lawson's "The Passionate Mind", or Steve #Silberman's "NeuroTribes" (which I'm also still working my way through BTW). The autism literature has more of what I'd consider scientific humility. It's taken for granted that autism is a profound topic, that it isn't easy to make progress with understanding it, and that much remains unsolved. But Hallowell and Ratey make it sound as if "the exciting new science of fMRI" (as they are pleased to call it) has illuminated #ADHD as thoroughly as anyone could wish, that the task-positive network (TPN) and the default mode network (DMN) are the solution to everything. It makes me feel talked down to โ€” and puts me on my guard. This is how hucksters talk.

I'm also reminded of a recent science news article I saw, about a new study purporting to refute the most basic assumption of #fMRI studies (which BTW are NOT new) โ€” namely, that the rate of blood flow in a brain area correlates closely with the level of neural activity. I haven't really looked into this yet, but if it's correct, much of what #fMRI has supposedly demonstrated will have to go back to the drawing board.

Here's a link to the news story on problems with #fMRI:

https://www.tum.de/en/news-and-events/all-news/press-releases/details/40-percent-of-mri-signals-do-not-correspond-to-actual-brain-activity

@autistics

40 percent of MRI signals misinterpreted

Interpretation of numerous MRI data may be incorrect: blood flow is not a reliable indicator of brain activity.

Now that I've just completed another work week and started another off week, I'm back to reading "ADHD 2.0" (#Hallowell and #Ratey 2021). One issue I'm noticing with it: relentless #extranormativity (normalization of extreme #extraversion and marginalization of #introversion). The authors assume, for example, widespread enthusiasm for entrepreneurship, which would be an absolute nightmare for me: all the schmoozing and networking with people I'd much rather never meet or interact with. This #extranormativity seems to be a pervasive problem with literature on #ADHD in general, as opposed to literature on autism, where if anything #introversion is taken as the norm.

It's reinforcing my impression that #AuDHD is a fundamentally different phenomenon from standalone #ADHD (without autism). Many, perhaps most, of the characteristics #Hallowell and #Ratey list for #ADHD fit me perfectly, but some others might as well be characteristics of Martians, they're so utterly alien to me.

@autistics

Der gefrorene Fluss von Ariel Lawhon โ€“ Eis, Recht und eine Frau, die Protokolle zur Waffe macht - Buchrezension

Eis, Recht, Wahrheit: Unsere Rezension zu Ariel Lawhons โ€žDer gefrorene Flussโ€œ โ€“ spoilerarme Inhaltsangabe, Analyse, historische Einordnung & Hรถrbuch-Fakten.

Lesering.de

Starting to read "ADHD 2.0" (#Hallowell and #Ratey 2021). At first it seemed perfect, a real breath of fresh air after "Taking Charge of Adult ADHD" (2nd edition, #Barkley 2022). Both authors of "ADHD 2.0" are ADHDers themselves. There was great emphasis on the positive potential of #ADHD โ€” especially welcome after Barkley's relentless pathologizing. They even write:

"A person with ADHD has the power of a Ferrari engine but with bicycle-strength brakes. It's the mismatch of engine power to braking capability that causes the problems."

I was immediately reminded of my own mismatch analogy for #kaleidotropic autism: trying to fly an F-16 with a control system designed for a Cessna โ€” with #AuDHD as an almost inevitable consequence. Not quite the same thing โ€” "control" is much more general than "braking" โ€” but much closer than anything I've ever seen before from any source other than myself. I was thinking: this book is going to be fantastic.

Then I skimmed ahead, into a part of the book I hadn't yet read continuously โ€” and found FAVORABLE references to Applied Behavior Analysis (#ABA). I'm assuming that for most adult autistics, THAT practice needs no introduction.

๐Ÿ˜ฑ ๐Ÿคฏ ๐Ÿคข ๐Ÿคฎ

And, unfortunately, advocacy of #ABA isn't the only example of drill-sergeant thinking that I found. The emphasis on discipline isn't anywhere near as extreme as in Barkley, but it's definitely there. Given the appreciable overlap between ADHD and literal juvenile delinquency, I can understand the temptation to go that route, but it's a very dangerous path to traverse โ€” and it definitely isn't for me. Probably not for anyone with #AuDHD as opposed to standalone #ADHD.

Of course, I admit โ€” and even emphasize โ€” that this is just a first impression from skimming material I haven't yet read continuously. I definitely hope that my final impression is different.

@autistics

@autistics Well, itโ€™s done. I've read Russell #Barkley's "Taking Charge of Adult ADHD" (2nd edition, 2022) cover to cover. Definitely not the most pleasant reading I've ever done, but highly informative. I intend to follow up with his definitive account of his research and theorizing, "Executive Functions: What They Are, How They Work, and Why They Evolved" (2015).

But not right away. This was about as stiff a dose of #Barkley as I can take at one sitting. Instead, the next book on my #ADHD reading list is "ADHD 2.0" by Edward M. #Hallowell and John J. #Ratey (2022). #Hallowell in particular comes highly recommended by several people here on Mastodon, both as an engaging writer and as a fellow ADHDer himself. (I'm also continuing to read #Silberman's "NeuroTribes", as well as numerous academic papers and blog posts about #autism; I haven't given up researching that in favor of #ADHD at all.)

When I do take up #Barkley's book of research and theory about executive functions, I won't exactly be holding my breath for a great enlightenment on the subject. For one thing, I'm becoming more convinced than ever that while #AuDHD is indeed a form of #ADHD, it is fundamentally different from #ADHD without #autism. I don't expect #Barkley's symptom lists to capture that difference. Much of what he writes about stereotypical #ADHD sounds exactly like me; enough so to justify a diagnosis by symptom-counting criteria. But other elements of the stereotype don't sound like me at all โ€” very much the opposite in fact. What I suspect is really going on, is that my #ADHD characteristics arise not from an absolute deficiency of executive control, but from a mismatch between the level of control available and the complexity of the spontaneous activity that needs to be controlled โ€” trying to fly an F-16 with a control system designed for a Cessna. I don't expect a symptom-list approach to capture an underlying reality like THAT at all.