Abstract:

Attention-Deficit/Hyperactivity Disorder (ADHD) is taken for granted as a neurobiological reality. Despite decades of medical research and treatment, ADHD prevalence continues to rise, with vexing differences between genders, races, and socioeconomic strata. This suggests ADHD may be socially constructed. To investigate, I studied 2 very different families, each including adolescent boys diagnosed with ADHD early in childhood: One, African American and living below the poverty line in a dangerous neighborhood; the other, White and living in affluent security. Using a novel method synthesizing phenomenology, embodied hermeneutic inquiry, and auto-photographic ethnography, I sought to explicate shared essential structures of ADHD, while maintaining contact with the textures of disparate lifeworlds. My hope was to acknowledge the suffering ADHD visits on families, while honoring the complexity of systemic forces at work, particularly for poor, racially oppressed families. By analyzing narratives and photographs from each of 7 participants (n = 7) through embodied hermeneutic inquiry, I constructed thick descriptions of each family's lifeworld, as organized into Ludwig Binswanger's 3 existential realms: Umwelt (environment); Mitwelt (relationships); Eigenwelt (inner-world). Then, bracketing this knowledge, I phenomenologically reduced descriptions of ADHD that were imbedded in the narratives, explicating 5 shared essential structures: Reifying behavior; Seeking relief from suffering; Experiencing help; Stabilizing the child-Self; Longing for the before. Lastly, reintroducing essence to thick description, I crafted a Textural-Structural Synthesis of ADHD, juxtaposing shared meaning with profound contextual differences. I discuss these results, adding perspectives on race, oppression, poverty, social sharedness, and interpersonal neurobiology, among others. This facilitates a social constructionist critique, and an alternative conception of ADHD, the latter via Maurice Merleau-Ponty's theory of vital structures. Finally, I envision alternatives for facing ADHD, emphasizing transpersonal and constructionist clinical approaches. This work has implications for changing commonly accepted ideas about ADHD, as well as how clinical and social psychologists study such phenomena.