Scattered Minds: The Origins and Healing of Attention Deficit Disorder

“Attunement” is the harmonious attachment relationship between an infant and a caretaker. More specifically, it refers to the caretaker’s responsive involvement in the infant’s emotional world. Maté believes this relationship is critically important to the long-term development of emotional self-regulation and attention; the absence of attunement is foundational to his theory of ADD and thus to the book’s overarching claims.

As opposed to the voluntary nervous system, the ANS is composed of the smooth muscles that line the body’s organs and operate involuntarily. The ANS is made up of the sympathetic nervous system and the parasympathetic nervous system. Maté cites the fact that both the ANS and emotions are processed by the same part of the cortex to support his contention that emotions influence the body’s physiological state, which is in turn key to his ideas about how ADD develops.

“Concordance” refers to the likelihood that two individuals will have the same genetic trait if one does. For example, Maté cites studies that compare identical twins with ADD, arguing that the scientific community erroneously ascribes causation to the concordance found in these studies.

A concept developed by Gordon Neufield, “counterwill” is an unconscious defensive reaction to coercion. Maté believes that counterwill is a functional aspect of infant and adolescent development that in ADD can become maladjusted and entrenched as an immature reaction to the fear of being controlled.

“Dissociation” is a term in clinical psychiatry that refers to specific symptoms of mental disconnection from one’s emotions or identity. Maté uses the term in a broader sense to refer to people with ADD’s tendency to anesthetize themselves to their surroundings as an emotional defense.

“Explicit memory” is the capacity to consciously recall specific feelings or events. Maté says that the retrieval of explicit memory triggers increased blood flow in the frontal lobes. Some ADD brains, he suggests, experience diminished blood flow in this region during stress, potentially explaining why memory difficulties can be a symptom of ADD.

“Implicit memory” is an encoded memory that is not consciously recollected. Maté believes that infant experiences stored in implicit memory banks are overwhelmingly responsible for adult personalities. In particular, he argues that the triggering of explicit memories explains why people with ADD so often respond strongly to perceived oppression. Understanding this process is key to healing ADD, according to Maté.

“Individuation” is a process of psychological development in which a person forms an authentic self and becomes self-motivated to differentiate themselves from others as an act of self-acceptance. Maté suggests that individuation, like many other stages of development, can remain unfinished in people with ADD, explaining many of its symptoms; a strongly combative personality, for example, is likely one that lacks a robust sense of itself. The importance of individuation also contributes to Maté’s cautious approach toward ADD medication, which he argues can interfere with the process.

“Oppositionality” is the immature and willfully contrarian defiance of authority. Maté believes that parents may ascribe intentionality to their child’s personality as a way of avoiding their own lack of emotional responsibility.

The OFC is the ventral surface of the frontal lobe of the brain; it is responsible for emotional self-regulation and attention. Maté particularly refers to the portion of the OFC behind the right eye, suggesting that when the OFC becomes impaired, brain connection with the cortex, the amygdala, and the reticular formation in the brain stem are inhibited, resulting in exaggerated experiences of rejection.

The PNS is the portion of the ANS that conserves energy and is associated with low-arousal states such as shame. Maté believes that chronic activation of the PNS represents an important stage in child development; if not resolved, however, that chronic activation can result in depression later in life.

Socialization is the process in which we learn to connect with other people and learn which actions are acceptable. Maté believes that socialization is a fundamental human drive to which secure attachment and a sense of autonomy are essential.

The SNS is the portion of the ANS that expends energy and creates high-arousal states such as anxiety. As with the PNS, Maté argues that chronic activation of the SNS represents a normal facet of child development. However, hyperactivity can occur if one becomes stuck in this state.