thinkythink

A Sense of Personal Space

I recently returned from Montana. My husband was working at the  National Folk Festival in Butte, and we attached a vacation to that trip. I've never spent time in the Rockies before and I have to say that it is in some ways culturally more foreign for me from most places I've been. During the festival, a friend pointed out something that helped me to understand why I was feeling so out-of-context: people give each other a lot more personal space ther than they do back East (or in Europe for that matter.) I suppose that in a place where there is so much physical space in your surroundings, well, people aren't used to being all crowded together.

I knew that "crowded" was a relative term, and in the Netherlands, one of the most densely populated countries on Earth, I learned strategies to deal with people being so crowded together that they would bump into each other all the time. This bumping-into was something I couldn't filter out for my ADD, so it exhausted me. On Saturdays at the Utrecht market, you can get caught in a sea of people that is comparable in Boston only to the crowd walking to the fireworks at First Night or on the Fourth of July, with the difference that then, you're swimming in a group with a common destination. At the market, everyone was trying to get off at their own stop along the way as it were, in the form of a flower or cheese stand, for example, or a bank. I think that it is a cultural crowd-coping mechanism in the Netherlands to just ignore other bodies as you travel from point A to B. I finally started holding my arms up to my sides, as a sort of shield, and when people walked into them somehow it got their attention and they'd apologize and give me an inch more of room. Plus, bumping into my arms is less tiring than bumping into my torso somehow.

Just as the Dutch are headed in different directions in their busy swarm at market, at the folk festival in Butte it seemed that people were just not accustomed to swarms of people at all. And so a far smaller number of people seemed to constitute a crowd and, in a narrow street, cause a pedestrian traffic jam.

But away from the crowd, I seemed to keep bumping into people. I wasn't picking up their cues at all; they needed me to wait longer (yeah right, wait?) for them to pass through the door or finish at the buffet before I came along. Go slower, take my time, and perhaps imagine giving them the amount of space they'd need if they were on horseback and not on foot.

Once I assimilated this fact (I didn't exactly get used to it on my short trip), I loved it out there. I miss the wide open already.

Doing in your head before doing in the world

I want to talk about an inattentive experience I'm having today. It's been a long while, luckily, since I've dealt with this one, but I must have just the right mix of fatigue, estrogen (big effect on the AD/HD), and piles of stuff to do. From working with my clients I think it's an experience a lot of predominantly inattentive type folks have, and maybe some non-ADD folks as well, but it's something with which people usually struggle without having it identified. It goes like this:

I have an errand or chore to do. I think of this task, then I start doing it--- in my head. I imagine all the details of it in sequence. It's the kind of visualization that you would think would be helpful if you were an athlete with a goal, and you actually intended to imagine it in mind-numbing detail.

Only you didn't mean to imagine it at all, and rather than being a tool of getting focused, it feels like something your mind is doing; it is going through a whole activity on its own, without your permission. It just goes there and does that. So I've gotten in the car, with all of my stuff (and in my case, the baby and his stuff). I've driven to 128 south, got off a few exits later and driven down another road to the running store. I've parked, got the baby out of his seat and into his stroller, walked over to the store, tried to explain to the salesperson that I want the cheaper running shoes, accepted the fact that this still puts me in the $90 range, tried them on, mulled and been uncertain, grumbled, purchased, and departed. Oh wait! I'm still at home thinking about doing this. Oh drat! now it seems tiring and boring, for I've gone through the mental motions already.

It's easier to deal with this mental rehearsal crap now that I:

• Know it happens
• Don't criticize myself for it
• Know that even though I've done it in my head, I don't necessarily have the energy/time to really do it today
• Let it go if I don't do it
• Watch the whole process just go by, like a river I'm sitting next to.
• See it as what my brain is up to, not what I'm choosing to do.
• Check in about my energy level and general state of being ~ why is my mind off in uncontrolled land today?
• Try to laugh it off

I have realized from my own experiences and talking with others that this is the kind of experience that people don't talk about that much as part of their inattentive experience. Yet it can be exhausting. And it can be confused with ruminating or obsessing. I see it more as my mind going off on an adventure without me... sound familiar to anyone?

Inattentive ADHD video on WebMD

Thanks to Pete Quily  and his blog for bringing my attention to this nice little video clip on WebMD about ADHD, which you can find here. This clip  starts out showing ADHD boys with hyperactivity, but then talks about, to paraphrase Tom Brown in the video, girls not getting diagnosed because they don't make enough trouble for other people, because they're not hyperactive. As is so common, it focuses only on children with ADHD, but it does so in the context of how we slip through the cracks, until later, or until, well, never, when we're predominantly inattentive.

Not discussed in the video but really important I think is how much impact it has when children and adults are suffering from unidentified ADHD for a long time. The video does touch on the important point that inattentive symptoms are invisible- and therefore disbelieved. All in all, an impressive job on the part of WebMD in a three-minute video. If you're really impatient, start at about 1:00 (one minute) to skip right to the inattentive point.

Focusing on Inattentive ADHD

Because I want to write about ADHD- predominantly inattentive type, I've been  thinking I ought to do a bit more reading on what others have said on the matter. I'm attracted to the subject because (1) I have ADHD, predominantly inattentive and (2) not that many people seem to talk about it. It seems like when I talk to clients about inattentive challenges, these massive blinking lights go off, because no one "got it" before. I hope I can blog about some of the stuff that I keep figuring out with clients over and over again, that we aren't finding elsewhere. But in the meantime, while it feels like there isn't much information out there, I realize I haven't exactly done an exhaustive literature review, so I'm starting my search. I'd like to ask my readers to share (in the comments) anything you've read about inattentive stuff that particularly struck you. I also wanted  to share this overview that I think is pretty terrific. I found it on CHADD's National Resource Center on AD/HD, and it is an information sheet called AD/HD Predominantly Inattentive Type and you can find it here.

I think it fairly addresses a number of the issues around diagnosis and definition of Inattentive Type. I particularly like fact that they cite a list of questions developed to help assess adults for inattentive symptoms:

1. Do you often make careless mistakes when you have to work on a boring and difficult project?

2. Do you often have difficulty keeping your attention when you are doing boring or repetitive work?

3. Do you often have difficulty concentrating on what people say to you, even when they are speaking to you directly?

4. Do you often have trouble wrapping up the final details of a project, once the challenging parts have been done?

5. Do you often have difficulty getting things in order when you have to do a task that requires organization?

6. When you have a task that requires a lot of thought, do you often avoid or delay getting started?

7. Do you often misplace or have difficulty finding things at home or at work?

8. Are you often distracted by activity or noise around you?

9. Do you often have problems remembering appointments or obligations?

Individuals who have significant chronic impairment from six or more of these symptoms are likely to have AD/HD if they also meet certain other criteria for diagnosis that are specified in the DSM-IV.

This list is useful if not exactly a complete reflection of the experience of inattentive symptoms. It also succeeds in  highlighting the fact that general ADHD assessments may not be sufficient for capturing adult and/or inattentive ADHD.

I'm also pretty impressed with the Wikipedia entry on the subject. What have you read that has helped you, struck a chord, or even made you mad- on this subject?