Joi Ito's Web

Joi Ito's conversation with the living web.

A: How many people with ADD does it take to change a light-bulb?
B: I don't know? How many?
A: Want to go to the movies?

Since I quit drinking, I've been doing a lot of talking and reading about addiction and the psychology of obsession. One path of inquiry lead me to the notion that obsessive compulsive disorder was often behind addictive behavior and that replacing one type of obsessive behavior with another wasn't a "cure" for the "disease". They seem to have a name for just about every kind of behavior, and interestingly enough, a medical "cure" for such diseases. I've been trying to face my demons and banish them so I can lead a more simple and fulfilling life.

Recently, someone told me that psychiatry was the only area of medicine where doctors "voted" to determine what sorts of behavior were considered diseases and should be treated. The assertion was that the drug companies created incentives for doctors to classify behaviors which had medical methods of neutralization as diseases. Many of these behaviors, my friend asserted, were natural human behaviors that some people had and didn't require a cure.

Now I'm back to trying to figure out what parts of my personality I should change and what parts of my personality are actually features and not bugs. Of course the first step is to know yourself and identify the demons and quirks. Most personality traits have benefits and drawbacks and designing your life to maximize the benefits and minimize the liabilities is probably a good thing.

Today, I had dinner with David Smith who has ADD. I think his ADD is worse than mine. We talked about a mutual friend who has, as David puts it, "terminal ADD". We talked about the hyper-focus that ADD provides and ways that you can use ADD to do things many people can't do. Harnessing ADD, rather than neutralizing it has interesting benefits. We talked about how modern society has allowed many people, who might have been dysfunctional in the past, to make valuable contributions to society. It's interesting how labels and the notion of disease can cause people to blame these things for their problems instead of trying to figure out how to turn these bugs into features. I realize that some people really do have diseases and I'm not trying to belittle their struggle. What I'm saying is that before we label ourselves and start taking therapy and drugs we ought to think about how all of these elements interact to create the human being that we are and place this in the unique context that each of us are in.


ADD to me isn't a disease that requires a cure. I'm terribly thankful my mom was wise enough to tell our school psychiatrist to go climb a tree when he recommended medicating me. (He was pretty sadistic, anyway.)

"ADD" has likely existed since the rise of consciousness in mankind. I often see it as a direct function of self-awareness, creativity, etc.

But self-medication is indeed a serious issue for those of us with ADD.

And how much of these "symptoms" of ADD are directly related to adapting to the wonderfully bewildering barrage of the information revol... ooo shiny! What is that?! *poingpoingpoing!* brb.

There is a wonderful story that a family friend tells about my niece. They asked her what she's interested in. She sat their thinking for a bit with her eyes twinkling... then she shouted... "EVERYTHING!" ;-)

ADD is definitely a feature not a disease. Only in a society where people are expected to sit on their asses for 8 hours a day from kindergarden till retirement would people even think of calling it a disease.

We as a society certainly are curing or improving certain 'dysfunctions' but we also seems to be generating plenty of new ones...

Joi, I love that story. Apparently my very first words - or at least my first complete sentence - was "What's that?".

I don't think I stopped asking that every other minute for years afterwards, and still ask it about every hour. I must have drove my mom completely and totally nuts.

Agreed. A feature, not a bug.

ADD: Attention Deficit ooh look fish..

the idea of 'terminal ADD' scares me.. why terminal.. O_O ?

i try to think of ADD as 'hyper threading' as even though i have ADD, i can still hang onto threads and fall back to them.

i think its about losing interest in something, picking up on another more mind captivating thing, regaining interest and continuing one with the previous thing.

That attention-deficit-disorder is a made-up psychiatric label.

By the way the story on "the vote" the did when ADD was invented can be read here:

The Onion once had a headline..."Ritalin Cures Next Picasso"

I have no idea whether or not I have ADD. Although I suspect I might, the chances of me ever getting a diagnosis are nil. The medical profession here would most likely click their tongues, look at me disapprovingly and then ask if I had anything serious wrong with me.

I don't care. When I hyperfocus on something creative I can get more done than usually even I could have imagined. The trouble only starts when something unsuitable catches my eye and I become unable to tear myself away from something that's not so healthy.

No one mention IRC, please. ;-)

I'm really not sure that I would want to be diagnosed or 'cured' anyway. I think being interested in everything and having a wide and varied CV is something that is grossly underrated.

Once upon a time, being a polymath was seen as a good thing - if you studied biology and geology and astronomy and languages, well, that was something to be admired. It's only our age of specialists that makes us polymaths look out of place, and it's only medical control-freakery that turns us into sick people.

i have often thought about the connection between addictive behavior and obsessive compulsive disorder, having lived with a girlfriend with truly incapacitating o.c.d., and myself going through varying stages of "drinking heavily and steadily" until finally hanging it up almost 2 years ago. although i am heavily skeptical and wary of the psychiatric industry, i have known and lived with people with truly debilitating manifestations of these disorders. i have also watched myself surf through the DSM-IV, marvelling at the fact that i seemed to fit the description of every mental illness in the book. (when in reality, hypochondria is the one that i most strictly resemble). if i allow myself to, (and i have, and do, often), i can characterize virtually any aspect of my behavior or personality as either a demon or an angel, but when all is said and done, balance seems to be key. everyone has behaviors of ADD and OCD, it is only when these behaviors take away from a person's ability to have a functional, worthwhile, reasonably happy life that they need to be evaluated. when i was drinking, i tended to see psychological abnormalities in my personality a whole lot more often. the reason for this was, i think, that my behavior and personality were pushed towards extremes, therefore everyone saw them and complained loudly to me about them. also, the notion that i was "self-medicating" for these conditions sounded pretty good, as though i wasn't getting the proper help i needed, and was just improvising a a nice mcgyver solution with the tools i had available. in reality, i mostly just liked to get drunk. and i liked it too much.

and now, i am afraid i am obsessively thinking and typing, when i should probably head to work. i still have my ADD and OCD tendencies, but without the booze as an artificial crutch and general fuel accelerant, all the quirks, demons, and abnormalities seem pretty manageable. i still have them, but they seem to stay much more in balance now, without a lot of fear and worry on my part that somehow i am not keeping them all in control.

sorry about the novel here joi, but if you truly have ADD, you probably stopped reading a while ago :-)

I was almost diagnosed with ADD myself, but then there was part of the diagnosis where I had to fill in some tests on a website, but I still havent done them all. And still havent managed to call my doctor (we're talking months), so I wonder if that means I am positively diagnosed? heh

Anyway, I know that for me, ADD has been both a blessing and a curse. However I did choose the wrong profession, being a programmer with ADD worked when I was skipping classes to do small programming projects... now when I am all grown up and work in larger projects, things get more complicated, since a quick hyperfocus moment isn't anything that helps you write 10 000 lines of code ;)

I enjoy being myself, and I don't mind being different from others.

This whole ADD thing reminds me of when I was a kid and they converted me from being a lefthander...
I still do everything with my left hand, except write... Unfortunately this created a side effect: I have trouble telling apart right and left. So when someone asks me where to go, I sometimes say the right while pointing left..heh

I think ADD should be harnessed, not treated.

Oh, and I could add that the first paragraph could look like this:

A: How many people with ADD does it take to BUY a replacement lightbulb?
B: I don't know? How many?
A: Wanna see a movie?

I went to the store like 6 times with the intention of buying a new lightbulb, and came out with something else. Took me 4 weeks to get that bulb replaced.

Beat that ;)

If you're interested in reading some more about ADD I can highly recommend two books. "Driven to Distration" is a well written introduction with great studies that drive home the author's points. I would recommend "Scattered Minds: A New Look at the Origins and Healing of Attention Deficit Disorder" by Gabor Mate not because I necessarily agree 100% with his thesis, but because it gave me another insightful way to look at my own ADD diagnosis. Also he does a wonderful job of showing how environment affects biology which affects environment. No nature/nuture battle.

It seems to me that deciding which parts of our character to change is arguably a lifelong process, not an event.

I have come to realize it's important to give ourselves a break on occasion and to just be happy we're who we are.

That also makes it easier to weave the periods of intense concentration together along a path that is directionally correct. (Without worrying that every second has to be exactly right).

Feature or Bug? Optimal behavior or maladaptive behavior? As with most elements of behavior in psychiatry / psychology the term ADD is an over simplification of a complex neural process.

The problem of ADD is not the type of behavior it represents but "when" and "in what environments" it is present. This becomes a question of what you do for a living for example. Switching from one task to another quickly can have many advantages in for example finding patterns in new information and making new connections between information. But at other times it is a real problem (i.e. when prolonged periods of concentration are required for tasks such as programming or writing).

The problem is not the behavior itself but the "control" of that behavior. If technology gave us the ability to control the switching of behavior so we could concentrate, zen like, when we needed to but also multi task when we needed then that would be optimal behavior. Unfortunately we do not currently have this ability or technology.

We also do not have the ability to perfectly choose what we do for a living and our contemporary method of life requires a great deal of prolonged concetration using only our thoughts. Without the use of our bodys to produce lots of brain input (as you would have when farming for example) our brains have the excess capacity to wander while searching for adequate stimulation (i.e. reading news, blogs or IRC as some have mentioned).

I have been considering practicing meditation (except I cannot seem to get around to actually going ;) to help me concentrate when I need to, which is very often. Meditation actually changes the structure of the brain and probably encourages the formation of neural connections that strengthen the control of behvaior switching and focus (between the orbito frontal cortex and amygdala). Various ADD drugs actually perform a similar function but by increasing the "power" (firing rate) of the current connections (which can be though of as a "brake" that stops us from moving from one task to another).

In short (if you skipped the text ;) ADD is both a feature and a bug, it depends on what you *need* to be doing at that particular time.

I was a hyper kid. It was nearly impossible to keep me focused on lessons. When I was out of school, I spent most of my time on the move, outdoors, playing with friends, getting into trouble. Later in life I mellowed enough to be able to pay attention and have found my energy to be a great asset.

Thinking back, I was one of the most "hyper" kids around. I am sure that if I were a kid today, I would have already been diagnosed with ADD and on medication. ADD is just a label that frustrated parents and teachers use to have an excuse to sedate kids who are a handful.

A Hyper Mind is a terrible thing to waste!

When my oldest son (now 16) was in elementary school, his teacher -- a good teacher and a good person -- wanted to have him evaluated for ADD, based on his behavior in the classroom. The school principal -- a good principal and a good person -- concurred with her. My son's mom, my then-wife, did a lot of research into ADD as a result. We spent a lot of time talking about her research and what she had discovered.

We came to the conclusion that for any given aspect of human behavior you want to look at, you can view individuals' behavior as lying somewhere along a spectrum, as opposed to being in one bucket or another. But spectra are confusing for people. We don't want to know that our child is a little more this or a little less that. We're used to medical diagnoses: benign or malignant; infected or cured; broken or healed. We like to think in simple terms, so we make buckets. We've created one called "ADD."

As it happens, there are all sorts of incentives for everyone to place a child into the ADD bucket:

Pharma: Sell more drugs.

Physician: Generate more income.

Principal: (in some cases) Obtain more school funding.

Teacher: (in some cases) Move child into separate class.

Parents: Reduce feeling of responsibility for acts of misbehavior by child.

Child: Reduce feeling of guilt for letting down parents.

Who doesn't have an incentive to label a kid as ADD? No one.

In the end, we decided to decline an evaluation for our son, so that he wouldn't be labeled as ADD, and to home school him for a while so that he could get more one-on-one attention. It's impossible to say whether that helped; after re-entering the public school system a couple of years later, it wasn't as if he was problem-free. But now, in the 10th grade, he's an honor roll student. I can still see signs of behavior in him that some would label ADD, and that doesn't bother me at all.

You should read The Myth of the ADD Child by Thomas Armstrong, Ph.D. Really an eye opener.

Two good friends of mine were both diagnosed ADD in college. Both really smart guys. They both look at the world in completely fresh and different ways. It is a joy to know them and be around them and get to see the world through their eyes as much as possible. I would hate to think that might have been squashed if they had been labeled ADD earlier and been told medication was necessary.

I think that the feature/bug conversation is too binary. ADD is a state of being that has its pros and cons. Some of it has to do with the choices we make in this world.

I'm what's considered a highly functional ADD case. Most of the tasks that i engage with are benefitted by my never ending shift in attention. This is how apophenia works. I can only make connections between disparate things because my brain is operating at a ridiculous speed, spiraling through unrelated material at any given point in time. But dear god is it difficult for me to sit down and pay attention to a lecture, write a paper or take an exam.

When they started testing me for this, i came up with a lot of OCD tendencies. Why? This is how i've managed to function with disparate attention. I insert obsessions into things to make certain that things get coped with. No big deal. There are lots of coping mechanisms when you decide you want attention. Meds are the easy way out. But, frankly, sleep and food and calm state of being work just as well... if you can get there. If you're lucky, you can just lead a life where you'll never need an attention span.

The book that helped me understand ADD was called Driven">">Driven to Distraction.

I don't know anything about ADD, but there are some schools of psychotherapy which reject the medical model entirely as applied to psyche.

CG Jung, for example, said that "the gods have become diseases." Zeus no longer rules Olympus, but the solar plexus, and produces curious specimens for the doctor's consulting room -- that's a rough quote.

James Hillman said that the soul sees by means of its afflictions, and that the eye and the wound are the same thing.

Now if that were the case, what would be thrown out if everything were treated as a bug to be fixed?

You can read a very thoughtful paper on this topic here:


Q. How many psychiatrists does it take to change a light-bulb?

A. Just one, but the light bulb's really gotta wanna change.

I don't know anything about ADD, but there are some schools of psychotherapy which reject the medical model entirely as applied to psyche.

CG Jung, for example, said that "the gods have become diseases." Zeus no longer rules Olympus, but the solar plexus, and produces curious specimens for the doctor's consulting room -- that's a rough quote.

James Hillman said that the soul sees by means of its afflictions, and that the eye and the wound are the same thing.

Now if that were the case, what would be thrown out if everything were treated as a bug to be fixed?

You can read a very thoughtful paper on this topic here:


Q. How many psychiatrists does it take to change a light-bulb?

A. Just one, but the light bulb's really gotta wanna change.

I don't know anything about ADD, but there are some schools of psychotherapy which reject the medical model entirely as applied to psyche.

CG Jung, for example, said that "the gods have become diseases." Zeus no longer rules Olympus, but the solar plexus, and produces curious specimens for the doctor's consulting room -- that's a rough quote.

James Hillman said that the soul sees by means of its afflictions, and that the eye and the wound are the same thing.

Now if that were the case, what would be thrown out if everything were treated as a bug to be fixed?

You can read a very thoughtful paper on this topic here:


Q. How many psychiatrists does it take to change a light-bulb?

A. Just one, but the light bulb's really gotta wanna change.

Thomas Szasz, M.D. likes to describe mental disorders as "problems in living" rather than as diseases.

Seems to me that many of these "problems in living" (ADD, mood disorders, etc.) are the result of maladaption of the brain to society. Or maybe it's the other way around. The human brain, rich in pattern recognition, creation and adaptation, is poorly adapted to sitting at a desk or in a cubicle, performing abstract tasks, quickly shifting assignments. Hence the rise of ADD.

This isn't to say that medical interventions aren't useful--just that truly effective treatment more likely involves a change in society making it more human.

While ADD is both a feature and a bug, this doesn't mean that medicating is a bad thing. First things first, I agree that there is probably a huge overdiagnosis of ADD, but I also contend that there is a medical basis for it (this comes from my Mum, who has done research on this). Both my brothers have ADD, and when medicated, lose the utterly random anti-social aspects of their behaviour, and can concentrate better. The primary bug of ADD is that it stops a person being able to control or even understand their behaviour. Medication removes this bug, and in doing so lessens the feature slightly, but is truly uncontrollable attention really a feature?

But yes, ADD (or ADHD even) is misnamed and generally applied to a lot of cases which are just natural energy without any drawbacks.

Our family just adopted a 14 year old girl from Kazakhstan. She was in a remote village orphanage surrounded by other kids with learning and physical challenges. She was misdiagnosed as a slow learner when she was 5 and sent to this particular orphanage.

It is amazing watching how fast she can process new things and multi task. She is incredibly active and inquisitive and learning our native english language so fast its amazing. She watchs and adapts and then trys and re-adapts. She can get a bit carried away processing all the new stimulus but is so raw and real it's been enlightening. Her learning style is multi dimensional. I don't think they knew what to do with her and couldn't keep up. As far as we know she wasn't medicated. If she would have been in the U.S. school system I know they probably would have labeled her ADD.

By druging our kids we are taking away the brightest minds to solve our future community and univeral challenges. Just thing of what would not get done in the world if everyone fit into the same learning box!

Maladaption of society to the person is a good way to look at the problem. As somebody who is very likely ADD, I have thought about getting diagnosed, but I have often wondered if solving the "problem" is the issue. Don't we need to come to terms with ourselves to be successful at some point? I have siblings who would put your addictions to shame, but as you note, the problem itself is often an adaptation which manifests itself in positive ways. My "solution" has been to look at my reasons for drinking, or the social pressures, and to find equivalent possitive social pressures. For example, I often want to go have a drink to be around women, though winding up drunk around women is self defeating. A year ago I started to take yoga, and found that not only were there more women around, but that yoga was really helpful for focus and relaxation. While I have not stopped drinking, I have eliminated the extremes, which is in my opinion the best solution.

Eric, I didn't stop reading, but skipped to the last sentence and had quite a good laugh!

Living with an alchoholic, I believe that addiction is related to deep psychological issues. Knowing yourself is probably the better cure than taking prescriptions that simply address the symptoms and not the cause of the imbalance. Hopefully through knowing yourself you can plan a course of action to change those parts of you that have caused the imbalance. (I offer you my feelings of support in this endeavor.) I also agree with you that giving any condition a label distances a person from really addressing the problem. Maybe through the process of letting go of one addiction for another less destructive one, a person can learn more about his/her compulsions and is able to transform the Beast into Beauty.

I've also come to understand that the present social conditions generate more addictive behavior than any other time. And probably it is a social illness that we have to help each other cure ourselves together as a society. I'm not sure if addiction and ADD is related.

I became really fascinated with the whole connection between ADD and entrepreneurship when I met David Giwerc last year. David is an ICF Master Certified Coach and the founder of the ADD Coach Academy, a long-distance training program for teaching coaches how to work with people with AD/HD.

As a result of my conversations with David, I took a look at the diagnostic criteria for AD/HD and was pretty shocked to find that I matched 15 out of 18 criteria! Interestingly, though, I only have 5 of the 16 problems and consequences frequently associated with AD/HD. In fact, I graduated 1st in my class from high school and summa cum laude from college -- hardly typical signs of ADD. Since I've never been diagnosed with it, and I'd certainly hesitate to self-diagnose it now, obviously somewhere along the way, based on my upbringing, I developed some coping skills such that those traits didn't become incapacitating for me.

I asked David to contribute a couple of articles on this for my site, which he did:

The AD/HD Entrepreneur: Most Entrepreneurs Have It - It's Just a Matter of Degree


The AD/HD Entrepreneur: How Your AD/HD Affects Your Business

Hope you'll find them useful/provocative.

Try this book:

"Attention Deficit Disorder is a disease that stigmatizes millions of Americans and causes many of them to fail--first in school, then later in adult life. It has been estimated that 90% of the prison population has ADD. This book takes a unique look at the disorder, suggesting that it is not really a disease, but rather an evolutionary adaptation to life in a hunting society. "

Interesting discussion. Here is my addition:

I didn't see anyone mention the (related to the posting topic) WIRED aritcle "The Geek Syndrome" which discusses ADD and Aspergers:

as well as the "AQ" test:

Score yourself at your own risk.

ADD *is* irresponsibly overdiagnosed, by supposedly reputable physicians. Viz:

Aerobic exercise involves the manner of muscles drawing on oxygen in the blood as well as fats and glucose that increase cardiovascular endurance. Aerobics is done in order to improve fitness, burn calories, shape the body, strengthen physical well-being, and maintaining fitness. There are different types of Aerobics, apart from a Warm up, a Cardio part, and a Cool down. There is another lesson that consists of Floor work, and Stretching.

Your body is always burning some fat but if you want to lose weight, you need to increase your activity to the point where your body starts to let go of some of its fat reserves. That means sustaining some activity. It takes about 20 minutes of aerobic activity before the body starts to burn its fat deposit. And fat-burning has an added bonus: if you can get your body into its fat-burning range, your metabolism stays elevated even after you’ve stopped exercising –for up to six hours!

Exercising aerobically means you are basically doing two things: helping your body take in more oxygen, which strengthens your heart and lungs, and over time allows you to achieve more physical work that you could not without aerobic exercise. Aerobic exercise also creates a situation in the body due to which fat that is stored somewhat out of reach, are accessed and burned in greater number than they are when you are at rest.

A post referred people to a site for referencing the deliberations of the Psychiatric profession. It is completely bogus.

The Citizens Commission on Human Rights (CCHR) was co-founded in 1969 by the Church of Scientology and Dr. Thomas Szasz, Professor of Psychiatry Emeritus at the State University of New York Upstate Medical University in Syracuse, to investigate and expose psychiatric violations of human rights. Today, it has more than 135 chapters in 34 countries.

ADHD affects all of us in one way or another. Obviously what the Psychiatrists see are extreme situations which they have labeled a disorder. Let's say you barf when you drink bad milk. On the other hand, let's say you barf after every meal. It's a matter of degree.
Self-diagnosis is not likely to be accurate. Disgnosis by a Psychologist is little better. Diagnosis by two Psychiatrists is probably certain.
Apophenia is with us always, especially when we think about ourselves.

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