‘We live in the age of ADHD.’ (Brendan Smialowski/Getty)
What does Donald Trump possess very little of, even as he keeps stealing lots from other people? The answer, of course, is attention. Close aides are said to keep their briefings strategically short in case his mind wanders. During speeches, he can ramble disconnectedly for hours. He can’t seem to hold a plan in mind for more than a moment: this week, trade with Spain was out, Zelensky was back in, and the President is now no longer sure he wants an Iran deal at all. If he lived in Britain, he would probably be offered a Personal Independence Payment on the spot.
Though many have been tempted to interpret Trump in terms of some secret masterplan for good or ill, according to the authors of a new book, Regime Change, the project is pointless: “Trump will often do simply whatever he feels like in the moment, frequently giving in to shockingly impulsive behavior.” His preferred stimulants seem to be cable news, late-night social media rants, and taking risks with global stability. When he was formulating his tariff plan, he is said to have forgotten to include China, before improvising on the spot, to the horror of economic advisors: “Put them in for ten.”
We live in the age of ADHD, and Trump seems a perfect symbol of our distracted, hyperadrenalised time — his own lack of an official diagnosis notwithstanding. It is estimated that around 3-4% of adults and 5% of children globally have the condition, which seems a rather conservative estimate in relation to the numbers of students, celebrities, and middle-aged women who think they have it. According to NHS figures, among young people who are classified as NEET — ie not in education, employment, or training —“20–34% are likely to have ADHD, most of whom will not be diagnosed”. Rising prevalence is costing the British taxpayer a fortune; but at a less dramatic level, it seems we are all a bit ADHD now. Interactive screens are moving the cultural baseline for excitement, making things formerly experienced in technicolour appear boringly black and white. Like the American President, we now only respond to fabulous tributes, thrilling conflicts, and bizarre sights — which is presumably why Westminster is currently obsessed with a man dressed as a bin. Meanwhile in the US, placing a bet is apparently now more common than reading a book.
Seemingly unable to countenance the influence of fast-moving culture upon our plastic brains, many medics and therapists continue to talk as if ADHD were as objectively determinable in a human breast as the presence of cancer or heart disease. But the fact remains that the concept is a collection of symptoms, in search of a distinctive neurobiological cause. Even allowing for the possibility of hardwired, lifelong cases, there is no established way to rule out false positives largely created by more ephemeral social conditions — as local councils know to their cost. And certainly, the therapeutic and pharmaceutical industries have no financial incentive to separate the sheep from the goats.
One under-explored tool in this area is phenomenology — though admittedly, the methodology I propose is unlikely to be immediately useful to PIP assessors. With some who exhibit the full set of DSM-approved symptoms, there is often not so much a deficit of attention, as a paralysing surfeit. The stream of consciousness is hijacked by insistent details: intriguing sounds or sights that interrupt the flow of a thought or an action, demanding they too be noticed and properly contemplated. There is also the phenomenon of hyperfocus — zooming in deeply for ages, often upon relatively eccentric or niche topics — meaning that the capacity to take in mundane information or carry out plans is reduced. If you are the mother of someone like this, be prepared to repeat every instruction twice. (Don’t ask me how I know this.)
Indeed, ADHD is frequently described as involving a sensation of powerlessness; an inability to direct the beam of attention, so that it feels like your mind is being yanked around involuntarily. A common metaphor is of someone else switching the channels for you. Whether or not this inability to take charge of the inner remote control counts as an impairment worthy of special dispensations from the state is a different question (I think not); but I am in no doubt that it describes a genuine psychological type.
An accompanying idiot’s guide says that this sort of brain is extra hungry for stimulation, due to a dopamine imbalance — though not, unfortunately, in a way that provides an easy test for the condition overall. The brain ranks the inner to-do list in terms of the jolt to the system that particular tasks will immediately provide — or not — rather than their importance in relation to the person’s longer-term goals. Activities involving a cheeky hit of adrenaline shoot straight to the top of the list, but this ranking is not based on rational decision-making. The unconscious brain has already set its priorities, well before awareness ever reaches the conscious mind.
If true, this hypothesis seems to explain the feeling of relative powerlessness over the direction of the mental spotlight quite well. Whenever you find yourself doing something, but with no idea why, it is tempting to disavow the action as not really something you “did” at all. Indeed, the philosopher Elizabeth Anscombe partly defined intentional actions as the very ones to which “why?” questions are applicable — as in, “towards what ultimate aim of yours is this particular action, here, now, supposed to act as a useful bridge?”.
For instance: why are you scribbling in that book? An intelligible answer would be that you are making notes, in order to remember certain points, in order to ace an interview, in order to get a particular job; a paradigm of a smoothly-related chain of reasons. Equally, although most people are capable of letting their minds wander, they can also move their attention around in order to fit with prior plans or intelligible purposes. You listen to the teacher, not because she is intrinsically fascinating, but in order to avoid punishment, or pass a test; you pay attention to the mess your house is in, not because you like staring at it, but in order to clean it up, so that you can then avoid disapproval from visitors.
It is this capacity to use background aims to control the flow of concentration, and so help produce efficient behaviour, that appears relatively lacking in some lifelong ADHD-ers. They have an “executive function disorder”, as the jargon goes. Marooned thoughts and perceptions crowd in as if from nowhere, without fitting into a discernible higher plan. It must be a bit like being Keir Starmer, but more interesting.
This framing fits with several philosophical accounts of attention itself. On one view, the role of the capacity for attention is, precisely, to select certain sense impressions and thoughts for their relevance to fruitful action. On a slightly different view, attention enables you to structure the contents of consciousness into foreground and background, important and trivial, in a way that fits with your prior beliefs, desires, intentions, and values. Either way, the power of attention is closely related to purposes and goals. People who find no clear demarcation in their minds between the central and the peripheral can still get utterly absorbed in a particular thought or sensation, and they often are; but they lack a kind of interior sorting hat for personal salience.
If this is roughly right, then it indicates some important differences with more culturally-induced forms of attentional deficit. In the latter case — say, with the kind of rapid onset ADHD that students get during the second year of university, or women sometimes acquire in middle-age — there is rarely any accompanying involuntary hyperfocus. Concentration cannot settle on anything at all for long. Equally, unlike in the involuntary case, there is often an intelligible rationale available for staying in this highly distractible, jittery mental state, and an associated set of social rewards and benefits, no matter how primitive and ultimately self-defeating they prove to be. For instance: I have no idea if Trump’s attentional issues are lifelong or acquired, but it seems clear that his frequent unpredictable switching of positions usefully unnerves his opponents.
Meanwhile, for those of us who are not world leaders, a different set of benefits attach to the restless magpie mindset. One of these is that you are always on a state of high alert, ready to pounce on the latest new popular thing, and reap any social rewards accordingly. Your mind has been suitably moulded to a virtual environment of endless novelty and outrage. You are primed for the emergence of high-status new trends or talking points, including — ironically — the ongoing trend of female influencers claiming they have ADHD. And thanks to fantasies encouraged by the virtual world, you can also cycle through gratifyingly shallow versions of intimacy, rage, sorrow, and love, before moving seamlessly onto the next sensation. You can ignore all the real difficulties in your life, lost in a trance.
But because in this case, being intensely distractible fits within a coherent means-end pattern of decision-making, it also follows that you could choose to do things differently, in theory anyway. Over time, you could train yourself to focus on what is genuinely important in your life rather than trivial, and to wrest control of the mental spotlight back towards more profitable ends. This is probably also true of the first set of ADHD-ers, to some extent — the ones who feel like they have lost the remote — but it will be a lot more difficult and stressful.
And there is a final intriguing aspect of this framing to think about. If the capacity for sustained mental attention really does require a background sense of purpose to guide it, then people who don’t feel much direction in life will surely be more likely to count as horribly distracted: NEETs, say, in receipt of government benefits, telling themselves they are too radically impaired to get a job. For young people in this unenviable position, there is presumably not much in life that seems worth focusing on for very long; so it is scarcely surprising if they feel aimless and mentally scattered as a result. One might even wonder which came first: the PIP or the ADHD.
