The inadequacy of ADHD: a philosophical contribution

ABSTRACT

Attention Deficit Hyperactivity Disorder (ADHD) is a widely spread diagnosis. The dominant paradigm of ADHD is biomedical where ADHD is defined as a brain disorder. At the same time, the legitimacy of the diagnosis is being questioned since it is unclear whether or not ADHD can be deemed a medical disorder in itself. The aim of this article is to critically assess the merits of understanding the diagnosis of ADHD as a medical condition defined as a brain disorder. This is being done using the seventeenth century philosopher Benedict Spinoza’s (1632–1677) notions of adequate and inadequate knowledge and his counterintuitive theory of mental health. Doing so it becomes clear that ADHD, however adequate it may seem, is founded on inadequate knowledge and that the legitimacy of the individual diagnosis should therefore be questioned on the grounds that on a long term scale it is passivizing and stigmatizing rather that liberating.

KEYWORDS:

• ADHD
• education
• ethics
• knowledge
• Spinoza

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; and International Classification of Diseases, Tenth Edition.

2. In the very moment of writing this article, one day in February, media all over Sweden is reporting that evidence has now been found revealing that ADHD is a disorder of the brain. The cause of this highly reported newsfeed was grounded in an article published in The Lancet. The referred article has 82 authors stating that their ‘cross-sectional mega-analysis’ by using evidence from neuroimaging ‘confirm … that patients with ADHD have altered brains; therefore ADHD is a disorder of the brain. This message is clear for clinicians to convey to parents and patients, which can help to reduce the stigma of ADHD and improve understanding of the disorder’ (Hoogman et al. 2017, 2). This rhetoric and the use of a large group of scientists to support the biomedical model of ADHD is much like the one Barkley together with 86 healthcare professionals presented in 2002: ‘We fear that inaccurate stories rendering ADHD as myth, fraud, or benign condition may cause thousands of sufferers not to seek treatment for their disorder’ (2002, 89, emphasis added).

3. Passages in Spinoza’s Ethics will be referred to using the following abbreviations: A(-xiom), c(-orollary), d(-emonstration), D(-efinition), p(-roposition), s(-cholium) and pref(-ace). DOA refers to D(-efinition) O(-f) the A(-ffects). Hence, E4p22c refers to the corollary of the 22nd proposition of part 4. All references to the Ethics are to Curley’s (Spinoza 1985) translation.

4. References to Spinoza’s Theological-Political Treatise (TTP) are to Curley’s (Spinoza 2016) translation.

5. For a good example see footnote 2.

Additional information

Notes on contributors

Mattias Nilsson Sjöberg

Mattias Nilsson Sjöberg’s research interest is in philosophy of education primarily targeting questions of social inclusion and diversity.

Johan Dahlbeck

Johan Dahlbeck is Associate Professor of Education and his research interest is in philosophy of education. He is the author of Spinoza and Education: Freedom, Understanding and Empowerment (Routledge, 2016).