“Interest-Based” versus “Importance-Based” Nervous Systems
I have an interesting new twist on ADHD. For some time I’ve been dissatisfied with the diagnostic term “Attention Deficit Hyperactivity Disorder.” The problem in ADHD is not a deficit of attention. Patients with ADHD often can pay sustained attention to something that interests them, such as a Washington Redskins game. They just can’t pay attention to something that should interest them, but doesn’t– like their business expense reports.
William W. Dobson, MD, has suggested a fresh way of thinking about the attention problems of people with ADHD. I’ve been seeing and enjoying Dr. Dodson’s articles for years. He has abundant clinical experience with patients with ADHD, and he is good at conveying clearcut practical advice. His November, 2006 article, Real World Office Management of ADHD in ADults, is available on line at www.psychiatrictimes.com
Dr. Dobson points out that most people have an “importance-based” attention span. If something is important, they pay attention to it, however reluctantly. Knowing that it is important helps them stay organized and productive. In contrast, persons with ADHD have an “interest-based” attention span. They pay attention if they’re interested. If not, they don’t — no matter how “important” the issue or topic is. The person with ADHD may know fully well that a topic is important, but that doesn’t help him or her get the job done. What helps the ADHD patient focus, in addition to interest, are novelty, challenge, and a sense of urgency brought on by a tight deadline or impending disaster. Under those circumstances they can produce. That often produces an unhappy, scattered life style which the patient endures and which other people criticize.
Dobson emphasizes in his article that patients with ADHD need medication. That’s nothing new. What is refreshing is his insistence that they need help using their ”interest- based” nervous system to accomplish more. One little technique Dobson suggests to adult ADHD patients is that they organize their life by using deadlines and colors.