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      1. Attention as a Process

John LeMay:

The attention process – it’s a process. This is not a localized phenomenon that happens in one portion of your brain or another portion of your brain. This is a coordinated effort by this massively complex organ that can do things that are truly amazing. One of the things that it can do that is truly amazing is to defend us. However, when we start spending a lot of energy, and energy is limited (remember you cannot create it), you’ve got to know when to hold them, know when to fold them, and know when to walk away – the three laws of thermodynamics.

You can’t create more energy. You’re going to lose some and you can only change the direction, in a sense, of that energy, you can only use that energy. That’s the way that the brain operates. If my body is using lots of energy to defend me, to think things out, to anxiously handle a social situation that I’m uncomfortable with, how much energy do I really have for school? I don’t have as much because my brain has to do those other complex calculations and my brain is a smart learning organ. It’s going to defend me as best it can.

Here’s attention as a process – I want you to think about this. Part of attention is arousal. Does that make sense? Part of it is also detection. Can I detect what’s important in the environment to pay attention to at any given moment? Part of it is about analysis. Am I noticing the nuances of whatever it is now that has my attention? Part of it is planning. What do I do about that? Part of it is targeting. This is what I am going to do and how I am going to do it. Then part of it is sustaining or letting go.

If I have a kid that comes in that I need to assess, I want to know how this kid is doing on all of these. Because this kid might be diagnosed as ADD, but it could be this is a kid that is struggling in arousal and detection, but has no problem sustaining his attention. Or this might be a kid who has difficulty with planning and targeting his behaviors, but no problem at all with getting aroused and oriented. All of them can end up looking like and diagnosed the way that we currently diagnose as ADD/ADHD.

Dr. Green:

Each of these operates on their own feedback loop. So the arousal asks the question: there was a stimulus, is it still a stimulus, yes or no? If it’s not, arousal is gone. If it’s yes, then the arousal is maintained. So, if there’s an arousal stimulus, but there is another stimulus internally that’s interpreting a threat that could be embarrassment, who knows, anything. The arousal occurs- is it still a problem? Yes, but it’s not as important as this threat; you’re gone. You haven’t even made it to the next level. Let’s say you get past it- then detection.  What is it? What if you need glasses and you can’t see clearly or you can’t hear it clearly. You can’t detect it. Your brain says it must not be important; gone. Oh, must have ADD.

No, but it would diagnose that way. Okay, you’ve detected it correctly; go to analysis. What if you have one of the many forms of dyslexia? Dyslexia is not simply reversal of letters, that doesn’t allow you to accurately analyze incoming data. Then analysis says nothing to analyze there- it’s broken; oh must have ADD. No. You get through the analysis and now we are up to the planning stage. What are we going to do about this? I don’t know. I’ve got so many other things to do. Right now there are all these threats- gone. Is it ADD? Don’t even know yet.

They appear distracted, and they are. Is it an intentional problem or is it a genuine internal distraction? Let’s say they get to a plan, they have to now interact. But if there is a deficit in the interaction, it’ll show up as a deficit in the attention. But it isn’t. They’ve already attended. Then finally we get to sustain. We are back to arousal. Sustain is maintained, because the loop is saying; yes, keep working on it, keep working on it.

Well, if you have already been taught that no matter how hard you try it won’t work, it’s broken. If you’ve already determined that there are threats present, it’s broken. We haven’t even diagnosed ADD yet, and yet it’s masqueraded and looks exactly like it. That’s why everyone raised their hand. Make sense? That’s us. We did that. Maybe what we are calling ADD is some conglomerate of a whole bunch of things that we now need to figure out what is going on. Is it possible that some of these so called inappropriate distractions are in fact appropriate? In which case, it’s not a dysfunction, it’s an adaptation.