Areas › Focus, starting, and ADHD › Shame and stigma
The idea that attention problems are a moral failing is older than the diagnosis itself. An early medical name for this put it down to defective moral control, so if you grew up hearing that you simply were not trying, you were hearing an echo of that.
The name changed several times after, through minimal brain dysfunction and a childhood hyperkinetic disorder, to what is now called ADHD. Each change moved it further from character and closer to how a brain develops and runs. Knowing that history gives you somewhere to put the blame that is not yourself. It belongs to a field that took a long time to understand what it was looking at.
Qur’an and Sunnah
No blame will be attached to the blind, the lame, the sick (Quran 24:61). A condition of the body is placed outside the language of blame there, which is exactly where an old moral label refused to put it.
لَّيۡسَ عَلَى ٱلۡأَعۡمَىٰ حَرَجࣱ وَلَا عَلَى ٱلۡأَعۡرَجِ حَرَجࣱ وَلَا عَلَى ٱلۡمَرِيضِ حَرَجࣱ وَلَا عَلَىٰٓ أَنفُسِكُمۡ أَن تَأۡكُلُواْ مِنۢ بُيُوتِكُمۡ أَوۡ بُيُوتِ ءَابَآئِكُمۡ أَوۡ بُيُوتِ أُمَّهَٰتِكُمۡ أَوۡ بُيُوتِ إِخۡوَٰنِكُمۡ أَوۡ بُيُوتِ أَخَوَٰتِكُمۡ أَوۡ بُيُوتِ أَعۡمَٰمِكُمۡ أَوۡ بُيُوتِ عَمَّٰتِكُمۡ أَوۡ بُيُوتِ أَخۡوَٰلِكُمۡ أَوۡ بُيُوتِ خَٰلَٰتِكُمۡ أَوۡ مَا مَلَكۡتُم مَّفَاتِحَهُۥٓ أَوۡ صَدِيقِكُمۡۚ لَيۡسَ عَلَيۡكُمۡ جُنَاحٌ أَن تَأۡكُلُواْ جَمِيعًا أَوۡ أَشۡتَاتࣰ اۚ فَإِذَا دَخَلۡتُم بُيُوتࣰ ا فَسَلِّمُواْ عَلَىٰٓ أَنفُسِكُمۡ تَحِيَّةࣰ مِّنۡ عِندِ ٱللَّهِ مُبَٰرَكَةࣰ طَيِّبَةࣰۚ كَذَٰلِكَ يُبَيِّنُ ٱللَّهُ لَكُمُ ٱلۡأٓيَٰتِ لَعَلَّكُمۡ تَعۡقِلُونَ
No blame will be attached to the blind, the lame, the sick.Whether you eat in your own houses, or those of your fathers, your mothers, your brothers, your sisters, your paternal uncles, your paternal aunts, your maternal uncles, your maternal aunts, houses you have the keys for, or any of your friends’ houses, you will not be blamed: you will not be blamed whether you eat in company or separately. When you enter any house, greet one another with a greeting of blessing and goodness as enjoined by God. This is how God makes His messages clear to you so that you may understand
Qur’an 24:61read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A systematic review and meta-analysis of a large body of research set out how internalised stigma, meaning the beliefs a person takes in about their own condition, relates to psychosocial and psychiatric outcomes for people living with mental illness. It does not show that learning the history of a label undoes any of that, and the underlying studies are observational. What it does establish is that the beliefs you carry about your own condition are not harmless background noise.
Livingston JD, Boyd JE. (2010). Correlates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis.. Social science & medicine (1982) doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Blame is easier to set down once you can see where it came from and that it was never a statement about you.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
ADD and ADHD are not two different things. ADD is the older public word for what is now called ADHD, inattentive type, and the quieter presentation is not a lighter version of it.
Before you offer anyone the upside of their ADHD, say the hard part out loud first. One patient's answer to being told it was a gift was to ask where he could return it.
The famous ADHD success stories are real and they are also the exception. The commoner story, for someone whose difficulty was never identified, is quietly dropping out of things and disappearing.