Scattered Minds: The Origins and Healing of Attention Deficit Disorder

Nonfiction | Book | Adult | Published in 1999

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Summary

Background

Chapter Summaries & Analyses

Introduction-Part 1

Part 2

Part 3

Part 4

Part 5

Part 6

Part 7

Key Figures

Themes

Index of Terms

Important Quotes

Essay Topics

Tools

Beta

Discussion Questions

Part 7Chapter Summaries & Analyses

Part 7: “Conclusion”

Part 7, Chapter 31 Summary: “I Never Saw the Trees: What Medications Can and Cannot Do”

Maté outlines seven factors to take into account when settling on whether medication is needed. The first is to consider whether the person with ADD wants to take the medication. Educational systems would often rather regulate a child with medication than change their own practices to meet the needs of individual children. Second, it is important to tailor the dosing of ADD medication to the individual’s needs and experiences. Third, the goal of medication should be to help the individual rather than to make their behavior more palatable to others. Fourth, adults must be realistic about what medication can and can’t accomplish; for example, drugs cannot resolve fears of intimacy or lack of self-knowledge, though they can improve concentration. Fifth, Maté finds it worrisome that for most people with ADD, medication is their only treatment; drugs should not be given in isolation or as a first resort. Sixth, someone taking medication for ADD must have some basic understanding of themselves to cope with the cognitive and emotional changes that medication brings; the exclusive reliance on medication can even undermine the long-term goal of developing an integrated self. Finally, Maté advises caution in attributing dramatic positive effects to medication alone; for instance, the introduction of medication can cause changes to interpersonal dynamics that positively influence the person with ADD.

Part 7, Chapter 32 Summary: “What It Means to Attend”

A common conundrum for adults with ADD is the feeling of having to tone themselves down, Maté says. North American culture, according to Maté, fears difference. Adults with ADD who try to adjust their or their child’s behavior to suit society are bound to generate anxiety and prevent healing. Maté believes that we cannot simply look at the individual to heal their ADD but must restructure society to facilitate personal development. Maté compares the state of medical knowledge about ADD to doctors learning the medical benefits of natural childbirth procedures that were long considered heretical. He draws three conclusions from this example. First, the medical world tends not to trust nature. Second, there are true things not taught in medical school. Third, sometimes patients must educate their doctors, particularly on the kind of support they need. Maté quotes Scott Peck, who defines love as an action in which one extends oneself to nurture another person’s spiritual and psychological growth. Maté suggests that parents try to be actively loving toward their children and that adults with ADD actively love themselves.

Part 7 Analysis

Maté’s conclusion consists of two contrasting chapters. Up until this point, Maté has focused largely on the interpersonal (and especially familial) roots of ADD, arguing that its prevention and treatment lie in how those closest to the person, as well as the individual with ADD, respond to them. In Part 7, Maté shifts his emphasis, discussing first a hyper-individual treatment (medication) and then a much more broadly social one (shifting North American society’s priorities).

In fact, the two are interrelated; Maté expresses frustration with the American desire for a quick fix with medication, implying that this desire stems from a broader disdain for nonconformity and devaluation of loving relationships. His Skepticism of the Illness Model in ADD Awareness and Treatment causes him to feel that many parents and teachers would rather tranquilize a child into submission than take their emotional experiences seriously.

However, it is not the use of medication that Maté disagrees with but its use as a first-line treatment. Ritalin, he says, can be very helpful in treating symptoms, but the focus must be on healing rather than control—that is, on the subjective experience of the person with ADD rather than on the behavior that is visible to others. This is also why Maté believes that medication should not be used unless the child is willing to take it. Otherwise, the child may perceive that they are only loved when medicated. Maté encourages parents to focus on the emotional needs of their children and prioritize long-term goals over short-term behavior control: “Much more difficult [than medication], and much more essential, is to address the issues of psychological security, family relationships, lifestyle, and self-esteem” (314). He further notes that the upsurge in ADD treatment coincides with the underfunding of school resources such as special education workers and school counselors, implying that US society is relying on medication to treat systemic social ills.

Maté has gestured toward those ills throughout the work. In the final chapter, he focuses in particular on the pressure to conform. People in American culture, he argues, fear being different. Consequently, they avoid addressing the pain and rejection they feel and shun people who are emotionally expressive. Since ADD is marked by intensity, the person with ADD may face isolation as a result of other people’s inability to sit with their pain. Maté feels that the medical community reinforces this scenario by not trusting natural processes of development. People with ADD, Maté says, should inform their care providers of how best to care for them.