ADHD subtype 2-[Inattention] & Hoarding- Using Cognitive Principle Therapy
Definition: ADHD (subtype 2 -Inattention):
A person with this subtype must have at least six of these nine symptoms, and very few of the symptoms of hyperactive-impulsive type:
- Not paying attention to detail
- Making careless mistakes
- Failing to pay attention and keep on task
- Not listening
- Being unable to follow or understand instructions
- Avoiding tasks that involve effort
- Being distracted
- Being forgetful
- Losing things that are needed to complete tasks
DEfinition: Hoarding:
According to the Anxiety and Depression Association of America (ADAA), hoarding is “the persistent difficulty discarding or parting with possessions, regardless of their actual value.” Some behaviors associated with hoarding include:
- Inability to throw away possessions or indecision on whether to keep something
- Increase in anxiety when attempting to throw something away
- Difficulty with organizing possessions, including indecision on where to put something
- Embarrassment about the quantity of possessions, sometimes resulting in living with no heat, electricity or broken appliances due to not wanting repair people to see your home
- Worry that others are touching your possessions
- Obsessive thoughts about possibly needing an item in the future
- Checking to make sure an item wasn’t accidently thrown away
- Loss of living space, social isolation, problems with relationships, financial difficulties because of loss of work time or compulsive buying of more items
How ADHD and hoarding are linked
A number of studies have looked at a possible link between hoarding tendencies and ADHD. A study completed in Canada in 2015 looked at hoarding tendencies in children and adolescents between the ages of 6 and 17 in an effort to determine if hoarding was an aspect of OCD. Their results showed that hoarding tendencies were present in children with and without OCD, however, they were more apparent in children with more inattentive ADHD symptoms than in those with OCD only. Another study, published in the journal Depression and Anxiety in 2013, linked childhood ADHD with hoarding tendencies later in life. This study found that children with ADHD, particularly inattentive type ADHD, were more likely to exhibit hoarding tendencies later in life than those children without ADHD in childhood.”
Cognitive Principle Matrix theory of ADHD type 2 and Hoarding
Cognitive Principle Matrix is based on the two mind theory, which is the comparative mind and predictive mind. The comparative mind enables us to choose between what we want [greed] and what we don’t want [fear] which are the primary drivers of human nature.
The Predictive mind
In recent years scientists have discovered that our human brain has a predictive system and a comparative system, with the predictive system being triggered first. Professor Lisa Feldman Barrett at Northern University stated in June, 2015 that the predictive brain works hierarchically, with predictions flowing downwards from the limbic system. For the predict mind to work there needs to be both focus and awareness.
Focus & Awareness and their effect on memory
Focus: Centre of interest or activity, focal point.
Awareness: Knowledge or perception of a situation or fact, consciousness. The enables the predict mind to understand “context” and make decisions in advance. Without context decision making stalls as the predictive mind returns to comparative thinking of “do I want this or not” This process creates anxiety because it uses the slower neural pathways as shown below.
The DMN [subconscious] works one million times faster than the TPN [conscious]. The predictive mind can work in both networks, but without awareness and context, it will only work in TPN using the comparative mind to find context, then predict. This process creates anxiety and all the symptoms of ADHD type 2 described above, because the conscious mind operates in working memory, with a capacity to only hold 12 seconds worth of information.
In a healthy system the short term and long term memories, which are held in the subconscious mind, are combined with current both external and internal data to form a prediction, leading to intuition and then decision making in the conscious mind.
The person with ADHD type 2 lacks healthy levels of both focus and awareness and can’t hold sufficient information in working memory to make a good prediction, which causes anxiety and leads to further distraction or avoidance and less focus.
Hoarding & OCD.
The intrusive thoughts of people with hoarding disorder are associated with their preoccupation regarding their possessions; specifically, parting with, or losing these possessions. Unlike spontaneous OCD obsessions, intrusive hoarding thoughts and resultant anxiety are not usually activated until faced with the prospect of losing or parting with possessions.
Hoarding as an Identity Issue-Default Mode Network.
The DMN is most commonly shown to be active when a person is not focused on the outside world and the brain is at wakeful rest, such as during daydreaming and mind-wandering, but it is also active when the individual is thinking about others, thinking about themselves, remembering the past, and planning for the future. The default mode network is known to be involved in many seemingly different functions
Andrews-Hanna, Jessica R. (2012-06-01). "The brains default network and its adaptive role in internal mentation" state the following:
“Information regarding the self:
- Autobiographical information: Memories of collection of events and facts about one’s self
- Self-reference: Referring to traits and descriptions of one’s self
- Emotion of one’s self: Reflecting about one’s own emotional state
Thinking about others:
- Theory of Mind: Thinking about the thoughts of others and what they might or might not know
- Emotions of other: Understanding the emotions of other people and empathizing with their feelings
- Moral reasoning: Determining just and unjust result of an action
- Social evaluations: Good-bad attitude judgments about social concepts
- Social categories: Reflecting on important social characteristics and status of a group
Remembering the past and thinking about the future:
- Remembering the past: Recalling events that happened in the past
- Imagining the future: Envisioning events that might happen in the future
- Episodic memory: Detailed memory related to specific events in time
- Story comprehension: Understanding and remembering a narrative
All of the above forms part of a person’s identity. If the ADHD person is not fully focused or aware when forming their memories as described above, then their identity will not be fully formed.
According to CPM theory the ADHD subtype 2 person then finds their identity and memory in the possessions they collect, which may relate to themselves or others. This would explain why they are so attached to them and get severe anxiety when they loose their possessions or they are taken away. It also explains why they have to acquire new possessions, just like a healthy person has to develop their identity.
Their identity is projected onto external objects, which they form attachments to.
Hoarding as a memory issue [not an identity issue]
The CPM theory is that hoarding is an external projection of what is lacking in the subconscious predictive mind, that is, information and a prediction on how to use it [context]. That is, why some hoarders will keep newspapers, magazines etc for future information, because they can’t trust their memory.
According to CPM theory ADHD type 2 and Hoarding are related, but the result may be in creating a false self-identity or may be a defense mechanism to reduce anxiety and stimulate memory.
