Monday, July 11, 2005

My Itchy Homunculus: ADD/ADHD and Compulsive Behavior

In the book Delivered From Distraction: Getting the Most out of Life with Attention Deficit Disorder, Drs. Hallowell and Ratey write something interesting:

People who have ADD often don't like how they feel inside. It is difficult to say exactly what they don't like about how they feel, except to say that they feel bored, or off, or logy, or at sea.

What can begin as a mildly unpleasant feeling can escalate in seconds into a veritable crisis. They feel they must do something to change how they feel. Within moments, they are operating on a level beyond their rational control.

It is in these moments that they can make impulsive, self-destructive decisions...

What they don't understand -- and the wide world certainly does not understand -- is that these reckless acts do stem from a biological need to alter their inner state. In pain, they feel compelled to seek relief immediately. It helps if they can develop a repertoire of adaptive, healthy ways to change their inner state.

To explain better what's going on, let me ask you to consider if you think the following people have anything in common:
  • The type A, hard-driving workaholic who can't relax
  • The so-called type T, or thrill-seeking individual
  • The extreme-sports athlete
  • The compulsive consumer of erotic literature
  • The sex addict
  • The compulsive gambler
  • The alcoholic or the person who can't quit smoking
  • The person who abuses other drugs
  • The compulsive overeater
  • The rage-o-holic
  • People who describe themselves as having "an addictive personality"
  • The adult with ADD
I suggest that they all have something in common. They all have an itch they can't ever quite scratch. Their attempts to scratch may lead them to become workaholics, or to take extreme risks, or to scratch the itch with drugs, alcohol, food, sex, or gambling. There are good ways to scratch and bad. (59-60.)

I don't know if I have ADD, but I know exactly what they mean by the "itch." Sometimes when I've been sitting in one spot for a while, or when I'm in a meeting, or when I'm trying to focus on a programming problem for more than an hour or so, or even if I'm home alone on a Sunday without any plans, there's a part of my brain that starts screaming, "Feed me! Feed me!" So, I go fire up a web browser or pull out a book and start rapidly downloading information to my brain. This usually works for a few hours, but then the voice gets worse: "More! More! More! Faster! Faster! Faster!" I can sate it for a while longer with online lightning chess or superfast tetris, but eventually, I need to start pulling out the heavy weapons: chocolate chip cookies. So far, a box of chocolate chip cookies has always done the trick. I sink into that food coma where my belly hurts and I feel... wonderful.

This technique of using increasingly heavy weapons of stimulation on the itchy little man in my brain has drawbacks, of course. It might seem like a good thing to be constantly driven to take in more and more data, but compulsive net-surfing and rushing through books aren't the best ways to learn. They are, however, great ways to procrastinate. And cookies obviously bring their own problems.

Being in the compulsive state in general isn't any good either. When I'm in this state -- when I'm scratching furiously at the itch -- I'm hardly breathing. I tense up and read, read, read, or play, play, play, or eat, eat, eat. I've had pain in my forearms and tingling in my hands for years which comes when I'm tense and goes away when I'm relaxed. Also, it's hard to focus on something complicated -- work, for example -- when you're cramming as much data/food into yourself as you can.

So what do the good doctors recommend? How can we scratch our itch without damaging ourselves or working against our own plans?

The best way to scratch the itch is to engage in some kind of creative activity. Play...

Connect with the discomfort you are feeling -- the itch -- and try to let it guide you to a place where you can transform it -- i.e., scratch it -- through creative activity...

[You] must make a plan, set up structures, and develop habits. At the top of the list for us adults who have ADD is to marry the right person and find the right job. Put ourselves in situations where our creativity can be valued and expressed. Avoid situations in which we will be tempted to swerve toward near-addictions or full addictions. Stay away from people who instill fear through ridicule.

And, above all, cultivate connections in which our best selves can emerge. Cultivate creative outlets -- with people, with activities, with pieces of music or periods of meditation -- that are always available to us, so that when we feel the itch, we have adaptive alternatives to the maladaptive patterns that can ruin our lives...

[W]hen you feel the itch you should try to bear with the pain, instead of suppressing it, and allow it to lead you through a labyrinth. The labyrinth may be a conversation that started with your feeling bored (a sure harbinger of the itch!). Instead of gulping down your drink to alleviate the boredom, you speak to the person attentively. You allow the creative process to lead you into the unknown territory called spontaneous conversation. Being who you are, if you stay at it, the chances are good that what began as a boring conversation will turn into an interesting one. The itch will be transformed into pleasure. Your creativity will have done the scratching. (64-65.)

They go on to list a couple of other methods of scratching: exercise, meditation, and prayer.

I think they're really on to something here. Too often I try to scratch that itch in all the wrong ways. Whenever I step back, take a deep breath, slow down, relax, and focus on what the little guy is telling me, my itchy little homunculus goes from psychopathic stimulation addict to wise teacher.

Sometimes, I need to go into a room, close the door, turn off everything that has a screen or speakers, close everything with words, and basically refuse to feed the itch for an hour or so. Eventually, it settles down, and I go back to normal human being.

Action items:
  • Work scheduled meditation times into my workday.
  • Learn to recognize the itch. When I start to feel it, I'll refrain from feeding it compulsively, let it settle down, and constructively channel it towards something creative like work, studying, or conversation.
    • Think about ways to ensure that I avoid compulsive behavior.
      • Perhaps a timer which beeps every 15-30 minutes. When it beeps, I decide whether what I'm doing at that moment is compulsive or useful.
      • I'll probably feel more relaxed at the end of the day if I've been resisting the maladaptive itching patterns. If I'm too tense when I leave work, I'll know I need to re-visit the issue.


At 8:15 PM, July 12, 2005, Blogger Douglas Cootey said...

You're on your way to conquering the problem. The first step is awareness of the problem, the second step is analysis, and the third step is change. I wrote a blog that touched on this subject ( which might interest you. There are interesting studies being done on the mind that explain this compulsion for stimulation.

At 5:06 AM, October 21, 2006, Anonymous Anonymous said...

I really liked the article and i have decided to:
1) stop eating junk food from the 24th Oct 2006
2)Meditate evryday

I hope i will succeed.
I am determined to.
AT the end of 30 days i intend to lose atleast 4 kgs of weight.


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