Groucho Marxism

Channel 4 courted controversy recently by airing a documentary entitled The Great ADHD Myth?, which centres on the struggles of a stereotypically hyperactive schoolboy named Mason. The show went to great lengths to stress that many people exhibit similar behaviour and questioned the wisdom of diagnosing such people with Attention Deficit Hyperactivity Disorder, or ADHD. The program is presented as being concerned only with uncovering the facts. In reality, however, it sets out to demonstrate that ADHD is not a genuine neurological disorder but is instead an invented social construct. Much of the program is taken up with ‘experiments’ designed to prove this conclusion which was clearly arrived at in advance.

It has since transpired that the words of one of the experts interviewed were, in her words, “cherry picked… and presented… out of context to make them fit into their narrative”. At one point the presenter, Max Pemberton, even resorts to taking ADHD medication himself. Quite what he was trying to prove with this little stunt is not entirely clear. Despite these obvious defects I suspect that the show’s central thesis would have been music to the ears of many. There seems to be a perception amongst a significant proportion of the population that neurological disorders like ADHD are essentially made up. This view was recently epitomized by ‘comedian’ Ricky Gervais, who went viral for mocking current trends around diagnoses for ADHD.

What does the science say? A comment in a recent edition of New Scientist helpfully debunks many of the claims put forward in the show. One claim made is that ADHD is a new condition, which if true would suggest that it is in fact a social construct. But documented descriptions of what we would now call ADHD can be found back as far as 1798, and the condition has been medically described many times since then under various different names. Whilst it is true that rates of diagnosis have increased rapidly in recent years, just 1% of the population of England is currently diagnosed with ADHD. Another claim made is that ADHD cannot be a real phenomenon as it cannot be diagnosed using a brain scan. But this is true of most, if not all, psychiatric and neurological conditions.

Pemberton seeks out a diagnosis for ADHD via an online assessment, presumably to demonstrate how easy it is to be diagnosed (Pemberton does not actually have ADHD). But in reality, ADHD is diagnosed via a lengthy process that includes multiple questionnaires and an interview. Having apparently been diagnosed, Pemberton is then handed a prescription for medication, the implication being that it is far too easy for people to get hold of ADHD medication even if they do not actually have the condition. There is certainly an argument that we need more data on the effects of long-term medication use. But what we do have is evidence that ADHD treatments – drug-based or otherwise – improve quality of life for those suffering with the condition.

The program in fact demonstrates this by taking Mason off his medication, only to find that his schoolwork and behaviour decline to the point that his parents are forced to put him back on the treatment. This effectively blows a hole right through the show’s central argument (they don’t mention that of course). It seems that in making this program, Channel 4 chose shock tactics over scientifically accurate reporting, presumably because they thought it would boost their ratings. They must have known that the show would strike a cord with a certain section of the population. Why are some people so unwilling to accept the reality ADHD? I think it is because its core traits look like personal choices rather than a medical condition.

Western capitalist society places a high value on hard work and self-control. When people succeed or fail, others tend to blame only personal effort. But as I have pointed out in previous blog posts, this idea is based on the fallacy that we have free will. In truth, all of our choices and actions are ultimately predetermined by physical processes. Nonetheless, societal emphasis on productivity, individual willpower, and self-sufficiency significantly hinders the acceptance of ADHD as a legitimate disability. Of course everyone gets distracted or feels restless at times. The problem is that sceptics will tend to use their own mild experiences to dismiss the disorder, ignoring the fact that ADHD is the result of hidden differences inside the brain.

Because people cannot physically see an external wound, they often misinterpret real neurological struggles as bad behaviour. Forgetfulness is judged as disrespect; fidgeting is viewed as rudeness; procrastination is labelled as laziness. We humans are often quick to judge others. The reason for that, I think, stems from our egos, which are always trying to exert their superiority over others’ egos. This makes it easy for us to pass judgement; conversely, displaying compassion and understanding requires overcoming your ego, which takes effort. It also requires giving up pre-existing beliefs, which can feel jarring. Some people clearly find it easier to reject ADHD rather than give up long-held beliefs on fairness and opportunity.

The strange thing is that many of those who reject ADHD as a real neurological phenomenon would consider themselves rational thinkers. Ricky Gervais, for example, is always going on about the superiority of science over religion, yet when it comes to ADHD his love for science apparently goes out of the window. As I have pointed out in a previous blog post, Gervais is clearly a man with an overly inflated sense of his own intelligence and importance. He is also a man with an unfortunate habit of ‘punching down’ with his comedy. Gervais’ recent statements on ADHD have nothing to do with science or rationality and instead serve as an object lesson on what can happen if you allow your ego to take control.