'Jumping to conclusions' - a less commonly recognised feature of ADHD

Published on 20 October 2023 at 16:58

Behavioural impulsivity is a well-recognized, often quite core, feature of ADHD. What is less commonly appreciated is the cognitive version of this, which takes the form of 'jumping to conclusions'. This occurs when a person bases a rapid conclusion on a superficial or impressionistic appraisal of a situation, or on an inadequate consideration of the relevant facts. A message or communication or piece of information may be misperceived or misunderstood, but the typical ADHD impatience means the person does not take the time and effort to suspend a conclusion until the reality has been properly ascertained. 

The capacity to think usefully and constructively does require effort, energy, and tolerance of uncertainty and frustration. Some people lack this tolerance. This form of thought disorder has been explored by certain psychoanalysts - such as Bion (1962). It can be viewed as a subtle form of psychotic functioning since the relationship with reality is impaired. In more extreme instances it becomes an overt psychosis, with delusions - since delusions themselves are a kind of 'jumping to conclusions'. Delusions are usually based on some element of reality, but one which is distorted and over-elaborated. The false conclusion is then believed to be true - and then acted upon. Bion suggested that in some people the psychotic part of the mind acts like a muscle - instead of thought, there is an expulsion of all that is painful or frustrating or anxiety evoking. Sometimes this expulsion takes the form of rage. 

During early development, the infant's evolving mind requires assistance from the mother's mind (or other primary caregiver), in applying thought and language to what is upsetting or painful. The good-enough mother uses her empathy and supplies soothing words to name and alleviate the emotional distress. In this way, the child's tolerance of pain and frustration, and capacity to think about these feelings (the capacity to 'mentalise') is facilitated. However, if the mother's lacks this capacity, or if she responds to the child's communications of distress with increased agitation or anger of her own, the child may experience this as an attack on his or her own mind and capacity to think. One result of this is that the child then becomes intolerant of thought - and an internal process of 'attacks on linking' takes place (Bion, 1959). These possibilities are of relevance in the case of ADHD because often the parent(s) too have ADHD - and so there can be a combination of maternal/parental intolerance of frustration and the child's inherent intolerance, giving rise to a malign mental state in the child - driven mad by the pain of thought and attacks on thought. 

It can sometimes be difficult to spot this kind of thought disorder because the person may appear predominantly sane and rational, but there may be times when an unwarranted belief or assumption suddenly comes into view, perhaps revealed by a passing remark. These can be like hidden areas of mini-psychosis in the mind of some people with ADHD. 

Energy psychotherapy modalities can be used to soothe and modify these mental states and processes - and also to 'decathect' the originating experiences. 

References:

Bion, W.R. (1959). Attacks on linking. In Second Thoughts. London. Heinmann 

Bion, W.R. (1962). Learning from Experience. London. Heinmann