Your Attention, Please: ADD? Waiting, Desolation 

Not infrequently a (perhaps unwitting) survivor of neglect shows up in my office toting a hefty diagnosis of Attention Deficit Disorder, (ADD.) They may have been so labeled by a know-it-all partner, possibly the very one who dragged them into this therapy. Maybe they were tagged with it in childhood, along with the accompanying prescription for amphetamine drugs. Never fond of diagnostic labels in general, (and particularly when assigned by one’s spouse or partner!) I listen with curiosity and perhaps some wariness. ADD and ADHD have seemed to be ready and convenient or “diagnoses du jour” in the last decade or two. They seem to me vague and ill defined, and frankly I shudder to think of all the kids growing up, often struggling on those speedy meds. It was only when I started studying neurofeedback that I began to understand a little more about what is going on in the brain of the attention afflicted. I wondered about the possible correlation between attentional difficulties and early neglect. Certain patterns began increasingly to make sense to me, as I connected dots I have often seen.

One of the first signature neglect “markers” I observed, back in the early days when my anecdotal research on neglect spontaneously began, was what I came to call the “Three P’s” of Neglect: Passivity, Procrastination and Paralysis. Particularly in the interpersonal world, these people appeared slow to initiate, follow through, complete things, and they were prone to collapse, feeling powerless or defeated. I began to see how these difficulties seemed to coincide with challenges around focus and concentration.

Studying neurofeedback, I began to understand what was to me a whole new world of brain frequencies. Previously I had been, aware of brain chemistry, and with the advent of what were then touted as the miraculous new SSRI antidepressants, many psychological complaints were explained in “chemical imbalance” language. But I was completely ignorant about the brain’s electrical pulses and impulses. Learning about trauma, I of course knew of the swinging trauma poles of hyperarousal and numbing. Through neurofeedback I began to “get” what that means in brain terms.

My neurofeedback focus from the start was on trauma, and primarily with calming down a hyper-aroused, terrified nervous system, I was perhaps surprised to learn what seemed counterintuitive to me: that attentional issues are treated by “training up” the brain. The pre-frontal (executive and thought centers) are firing too “low,” meaning at slow, maybe “too” low of frequencies. This seemed counterintuitive to me, as I had previously associated ADD type complaints with rapid shifts of attention, and hyperactivity, so I had previously simply assumed a speedy brain. However, continuing to see the co-occurrence of attentional issues and neglect histories piqued my curiosity. What might this mean?


I was always baffled (and sometimes admittedly dismayed,) by the way that my husband, the quintessential child of neglect, coped with the annoyances of all-too-common Bay Area bumper-to-bumper traffic. If we found ourselves mired in a jam, he would swiftly grab the nearest exit, jump off the freeway, and then follow a circuitous seemingly endless zigging and zagging route of surface streets, getting us to our destination probably no sooner, than had we continued to crawl with the glacial freeway traffic. But he always said, it was a phenomenal relief to simply be moving. Similarly, standing in lines was pretty out of the question for us. Go to a restaurant without a reservation? No way! Waiting and boredom are an agony for the child of neglect, and I began increasingly to observe this unbearable intolerance, the excruciating impatience and aversion to dead or empty time. Even if the alternative was pretty darn unpleasant.

I imagine an infant alone in the dark, the cold and vacuous crib, no one around; and the child not knowing if and when there ever would be again. Infants are not designed to be alone, certainly the tiny ones. The little brain with nothing to resonate to is lost in space, floating untethered without gravity, like a stray astronaut in a dark, limitless stratosphere. Terrifying, and desperately lonely. Attachment being a survival need, the loss, absence or withdrawal of attachment will feel life threatening to the vulnerable little one. Traumatic. I imagine that yawning, empty time is enough reminiscent of that trauma, as to activate it. Preventing or avoiding the stimulus, the reminder, becomes a desperately needed defense, a lifesaver. Thinking about our maze of urban circling in that way, made more sense, and certainly inspired more compassionate patience on my part. Many a child of neglect will default to all sorts of seemingly “crazy” strategies to avoid waiting. On some level it is for many, a matter of survival, or it feels that way.

Similarly, for the child of neglect, boredom is a killer. Sometimes even when the alternative is another horror that I have come to call “hand grenades.” I remember one couple I saw. If our session seemed to loll off into what might seem dull, unmoving low energy, the excruciatingly bored partner would shatter the placid space with a comment so outrageously provocative, or specifically objectionable to the other partner’s sensibilities, that she would fly into an instantaneous, paroxysmic rage, It was certainly not pleasant, but did liven things up, and relieve the deathly emptiness. Or him, it beat the alternative.


I also discovered that if I encountered a new client with whom I felt in myself a leaden weight of uncharacteristic boredom or sleepiness, it was again, a clue or marker; perhaps a window into the dark desolation of that probably unremembered but traumatically relived, infant’s world. For me, boredom is so “ego dystonic,” such an unfamiliar state, that it stands out as immediately noteworthy, and generally points to a sense of contactlessness: simply not connecting with the other. I then have to wonder what I am being invited to experience and to know about this person’s inner world. How much of their early life was plagued by enduring the lonely freeze: the absence and/or loss of the beloved other? The withdrawal of that attachment figure, is similarly hugely traumatic, and perhaps the “shock” of that, or some other experienced abuse, are the rare impetus or catalyst to wake up the bleary little brain, and bring a little “life.” How sad to feel alive via experiencing threat and pain.

The brain as we know, develops in resonance, the right hemisphere of the primary caregiver’s brain in a gentle reciprocal dance with the developing right hemisphere of the infant; the stimulation of the deep recess of the brainstem. We are learning more about how the incipient being and sense of self comes into existence. It makes sense that the under-stimulated brain would be perhaps sluggish or slow, that existence would be in question, that movement might be a godsend, or at least a breath of fresh air.

Because my “study” has been anecdotal and hypothetical, I have asked Ruth Lanius, the renowned expert on the neuroscience of trauma and attachment, if there is merit to such connecting of the dots, or such an interpretation of what I observe. Although there is no formal research we are aware of as of yet, she has consistently agreed. Meanwhile I strive for patience and understanding, and to avoid rush hour when we can!

Today’s Song:

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