Article
Attention
Comment
Psychology
6 min read

Paying attention to ADHD– is it really just a fad?

Media fixation with ADHD caught Henna Cundill’s eye, so she decided to investigate its struggles and superpowers.
From a darkly shadowed face, a single illuminated eye stares.
Brands&People on Unsplash.

In a feat of irony, attention deficit hyperactivity disorder (commonly known as ADHD) is now getting a lot of attention. For example, between 28 and 31 January The Times newspaper published one article per day about ADHD. Intrigued, I looked back over the past few months, and I found that The Times has averaged 8 to 10 articles per month which are either partly or exclusively about this topic. These range from celebrity diagnoses to handwringing over the “troubling rise” in incidents of the condition, to concerns about parents gaming the system to get their children disability payments or extra time in exams.  

With all this media hype, it is little wonder that some commentators are inclined to dismiss ADHD as a fad. Scroll through the comments beneath each article, and you will reliably find the rallying cry of, “We didn’t have ADHD in my day!” followed by the patient responses of those who try to correct this fallacy.  

While the high public profile of ADHD is new, the condition itself is not. As early as the mid-1700s a Professor of Medicine called Melchior Adam Weikard was describing patients who were “unwary, careless, and flighty” – behaving in ways governed by impulse, and showing poor skills in punctuality, accuracy, and having an inability to complete tasks, to the detriment of their mental health. His description is of its day. For example, and somewhat amusingly, Weikard (himself German, but at this point living in Russia) also described his patients as follows:  

Compared to an attentive and considerate person such a jumpy person may act like a young Frenchman does in comparison to a mature Englishman. 

Even so, Weikard did not unconsciously adopt all the prejudices and stereotypes of his context: he broke firmly with existing medical consensus when he diagnosed these patients as having a “dysregulation in cerebral fibres” – rather than attributing their difficulties to astrological misalignments or demon possession.  

By characterising ADHD as a brain-based condition, Weikard was ahead of his time, and we’ve come a long way since then. This is not the place to chart the whole biography of ADHD, suffice to say that when someone rolls their eyes and declares dismissively, “We didn’t have ADHD in my day…” – they are either over 300 years old or not talking like a mature Englishman, even if they read The Times.  

The negative side of the condition as being in a constant fight with one’s own thoughts and senses – these are doughty opponents, they always know where to find you, and they only sleep when you do. 

Another thing that is not new, despite what cynical commentators might seek to imply, is the treatment of some aspects of ADHD with medication.  

Doctors have been prescribing amphetamines to patients with ADHD since at least the 1950s. Yet now those medications are in short supply. Contrary to the media hype, fewer than 1 in 10 people with an ADHD diagnosis take prescribed medication, but for some of those who do it can be a lifeline – calming down a washing machine mind that is stuck on constant spin.  

One acquaintance of mine has taken to anxiously touring the local pharmacies, driving to neighbouring towns and villages, desperate to get her prescription filled.  

Another is passing her own tablets on to her son, whose prescribed supply ran out sooner. Sharing prescription medication is, I am duty-bound to add, an illegal practice – but it is hard to expect a parent to medicate themselves whilst seeing their own child struggle to attend school, to complete exam papers and to just generally feel (and I quote) “like a normal person.”  

People who have ADHD sometimes describe the negative side of the condition as being in a constant fight with one’s own thoughts and senses – these are doughty opponents, they always know where to find you, and they only sleep when you do.   

This is not to overlook that there are positives to ADHD too – it is often pointed out that the condition entails a degree of “superpower.” A person living with ADHD may have an incredible ability to focus on one difficult problem to the exclusion of all else, and thus solve it, perhaps devising creative solutions that elude those with a more pedestrian style of thought.  

Also, it is common for people who live with ADHD to be dynamic conversationalists, with high social intelligence and empathy, priming them for success at tasks like broadcasting and debating. Many elite athletes also live with ADHD and say that they able to strive for excellence due to their restless energy and resilience in the face of tough training regimes.  

Given the mixed bag of struggles and superpowers, there is a raging debate about whether ADHD should even be considered as pathology, or just as a neurodivergent way of being human. I suspect there is no right or wrong answer to this – for each person who lives with ADHD it depends on their own experience and how they feel it helps or hinders them to live the life they choose. Neither is it a binary choice: more than one of my own acquaintances who live with ADHD has described themselves as being in a “love-hate relationship” with their neurodivergence.   

ADHD challenges me to unfold my mind too – to become ever more aware and appreciative of the fact that there are many ways to be human. 

Neurodiversity, like any kind of diversity, challenges the way we live to together in communities, choosing or refusing to show empathy towards those who are perceived as ‘other’. There are several places in the Bible where human interconnectedness is likened to the human body – made up of many different parts, with each member dependent on the other for the wellbeing of the body as a whole. In one of his letters, St Paul wrote, “If the whole body were an eye, where would the hearing be? Or if the whole body were an ear, where would the sense of smell be?” Society needs problem solvers, communicators, high achievers, even while society also needs people who can structure, plan and maintain consistency – and above all, society needs these different neurotypes to work together with a certain amount of mutual understanding and trust.  

Reflecting further on the body metaphor, Paul also wrote this: “If one part of the body suffers, the whole body suffers with it.” It is estimated that about 5 per cent of people in the UK has ADHD, so it is likely that includes someone you know. The majority don’t take regular meds, but if you are connected to someone who is usually reliant on these, the next few months may be a time of particular stress and anxiety, as the current medication shortage is expected to continue into late spring. This affects not just those living with ADHD, but all of us, as we live together in our families, communities, and networks. Not everyone chooses to be open about having an ADHD diagnosis, but if they are, now might be a good time to ask them how they experience this condition, both with its positives and negatives, and how you can support them if they are managing without their usual prescription. 

The body metaphor, and Paul’s teaching around it, reminds us that diversity is no accident, God has always been attentive to those who feel divergent or far from the centre, as Jesus affirmed when he announced his ministry would be for the poor, the prisoners, the disabled and the oppressed. The psalmist too, observes that God’s attention and concern for us is so complete, that one is “…hemmed in, before and behind” – even if one strays to the very ends of the Earth, or drives to the pharmacy in the next village. Thus, while the media circus may be new, we can be sure that God has always been attentive to those with ADHD, and wider society is called to be likewise. 

Writing for The Times, Esther Walker describes ADHD as “…the health story that keeps unfolding.” Well, certainly every time I unfold my newspaper, there it is again. But ADHD challenges me to unfold my mind too – to become ever more aware and appreciative of the fact that there are many ways to be human: usually complex, sometimes difficult, often brilliant, and always interconnected.  

Article
AI
Culture
Generosity
Psychology
Virtues
5 min read

AI will never codify the unruly instructions that make us human

The many exceptions to the rules are what make us human.
A desperate man wearing 18th century clothes holds candlesticks
Jean Valjean and the candlesticks, in Les Misérables.

On average, students with surnames beginning in the letters A-E get higher grades than those who come later in the alphabet. Good looking people get more favourable divorce settlements through the courts, and higher payouts for damages. Tall people are more likely to get promoted than their shorter colleagues, and judges give out harsher sentences just before lunch. It is clear that human judgement is problematically biased – sometimes with significant consequences. 

But imagine you were on the receiving end of such treatment, and wanted to appeal your overly harsh sentence, your unfair court settlement or your punitive essay grade: is Artificial Intelligence the answer? Is AI intelligent enough to review the evidence, consider the rules, ignore human vagaries, and issue an impartial, more sophisticated outcome?  

In many cases, the short answer is yes. Conveniently, AI can review 50 CVs, conduct 50 “chatbot” style interviews, and identify which candidates best fit the criteria for promotion. But is the short and convenient answer always what we want? In their recent publication, As If Human: Ethics and Artificial Intelligence, Nigel Shadbolt and Roger Hampson discuss research which shows that, if wrongly condemned to be shot by a military court but given one last appeal, most people would prefer to appeal in person to a human judge than have the facts of their case reviewed by an AI computer. Likewise, terminally ill patients indicate a preference for doctor’s opinions over computer calculations on when to withdraw life sustaining treatment, even though a computer has a higher predictive power to judge when someone’s life might be coming to an end. This preference may seem counterintuitive, but apparently the cold impartiality—and at times, the impenetrability—of machine logic might work for promotions, but fails to satisfy the desire for human dignity when it comes to matters of life and death.  

In addition, Shadbolt and Hampson make the point that AI is actually much less intelligent than many of us tend to think. An AI machine can be instructed to apply certain rules to decision making and can apply those rules even in quite complex situations, but the determination of those rules can only happen in one of two ways: either the rules must be invented or predetermined by whoever programmes the machine, or the rules must be observable to a “Large Language Model” AI when it scrapes the internet to observe common and typical aspects of human behaviour.  

The former option, deciding the rules in advance, is by no means straightforward. Humans abide by a complex web of intersecting ethical codes, often slipping seamlessly between utilitarianism (what achieves the most amount of good for the most amount of people?) virtue ethics (what makes me a good person?) and theological or deontological ideas (what does God or wider society expect me to do?) This complexity, as Shadbolt and Hampson observe, means that: 

“Contemporary intellectual discourse has not even the beginnings of an agreed universal basis for notions of good and evil, or right and wrong.”  

The solution might be option two – to ask AI to do a data scrape of human behaviour and use its superior processing power to determine if there actually is some sort of universal basis to our ethical codes, perhaps one that humanity hasn’t noticed yet. For example, you might instruct a large language model AI to find 1,000,000 instances of a particular pro-social act, such as generous giving, and from that to determine a universal set of rules for what counts as generosity. This is an experiment that has not yet been done, probably because it is unlikely to yield satisfactory results. After all, what is real generosity? Isn’t the truly generous person one who makes a generous gesture even when it is not socially appropriate to do so? The rule of real generosity is that it breaks the rules.  

Generosity is not the only human virtue which defies being codified – mercy falls at exactly the same hurdle. AI can never learn to be merciful, because showing mercy involves breaking a rule without having a different rule or sufficient cause to tell it to do so. Stealing is wrong, this is a rule we almost all learn from childhood. But in the famous opening to Les Misérables, Jean Valjean, a destitute convict, steals some silverware from Bishop Myriel who has provided him with hospitality. Valjean is soon caught by the police and faces a lifetime of imprisonment and forced labour for his crime. Yet the Bishop shows him mercy, falsely informing the police that the silverware was a gift and even adding two further candlesticks to the swag. Stealing is, objectively, still wrong, but the rule is temporarily suspended, or superseded, by the bishop’s wholly unruly act of mercy.   

Teaching his followers one day, Jesus stunned the crowd with a catalogue of unruly instructions. He said, “Give to everyone who asks of you,” and “Love your enemies” and “Do good to those who hate you.” The Gospel writers record that the crowd were amazed, astonished, even panicked! These were rules that challenged many assumptions about the “right” way to live – many of the social and religious “rules” of the day. And Jesus modelled this unruly way of life too – actively healing people on the designated day of rest, dining with social outcasts and having contact with those who had “unclean” illnesses such as leprosy. Overall, the message of Jesus was loud and clear, people matter more than rules.  

AI will never understand this, because to an AI people don’t actually exist, only rules exist. Rules can be programmed in manually or extracted from a data scrape, and one rule can be superseded by another rule, but beyond that a rule can never just be illogically or irrationally broken by a machine. Put more simply, AI can show us in a simplistic way what fairness ought to look like and can protect a judge from being punitive just because they are a bit hungry. There are many positive applications to the use of AI in overcoming humanity’s unconscious and illogical biases. But at the end of the day, only a human can look Jean Valjean in the eye and say, “Here, take these candlesticks too.”   

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