After 5.5 years, the CoCA project has come to an end. In this large-scale European research project, an interdisciplinary group of researchers investigated comorbid conditions of ADHD. They particularly focussed on depression, anxiety, substance use disorder and obesity, as these conditions frequently co-occur with ADHD in adulthood.
What has this extensive study brought us? Experts dr. Catharina Hartman (University Medical Center Groningen, The Netherlands) and prof. dr. Andreas Reif (University Hospital Frankfurt, Germany) were invited by Jonathan Marx for an interview on the online radio program Go To Health Media. In this program they talk about several aspects of the CoCA project: How often do comorbid conditions co-occur with ADHD? What do the genetics of ADHD comorbidities tell us? What should clinicians do to prevent or reduce these comorbidities in ADHD?
As professor Andreas Reif summarizes at the end of the interview, the main things that we learned from the CoCA project are:
Comorbidity in ADHD is a very big problem. Adults with ADHD frequently have co-occuring conditions such as depression, anxiety, obesity and to a bit lesser extent substance use disorder.
The type and prevalence of comorbidities differ between men and women.
There is considerable genetic overlap between ADHD and comorbid conditions. We think that at least part of the overlap between comorbidities is caused by genetic effects (next to environmental effects that also play a role).
The dopamine system plays an important role in comorbidity, through influencing brain processes.
Disturbances in the circadian system (i.e. sleep cycle) are unlikely to play a causal role in these comorbidities, but they might be a consequence.
Clinicans should look out for comorbidities when they treat ADHD patients, and inform their patients about their increased risk to develop comorbidities so that they can take preventive measures (i.e. be careful with alcohol to avoid substance use disorder). Secondly, clinicians should actively look out for ADHD symptoms when treating conditions such as depression, anxiety, substance use disorder or obesity.
Watch the full interview with both experts by clicking on the image below:
This year’s ADHD Awareness Month was themed “ADHD myths and facts, know the difference”. As scientists, we feel that it is our role to spread the facts about ADHD. But what myths are there about ADHD? To get a better idea of this, we chose to interview people and just ask them what they know about ADHD. What are the symptoms? How do you get ADHD? Can adults have ADHD?
The people that we interviewed actually were quite well informed about ADHD. Most know that people with ADHD have problems with controlling their attention, with sitting still and that they often have a lot of energy. And about half the people that we interviewed suspect that also adults can have ADHD. But we also noticed some myths.
Myth 1: People with ADHD are always active and have a lot of energy
ADHD is not just characterised by hyperactivity and restlessness. Many people with ADHD are actually quite capable of sitting still, but suffer more from a kind of inner restlessness and mindwandering. Also problems with focussing attention are very typical for ADHD, and there are people who only have this inattentive ADHD subtype, without the hyperactivity. What many people also don’t know is that people with ADHD often suffer from emotional dysregulation such as regalting your emotions and easily getting irritable or angry.
Myth 2: Only children can have ADHD
Although ADHD is wellknown in children, adults can also have ADHD. It is estimated that around 15% of the children with ADHD will continue to have the full diagnosis in adulthood. But about 60 – 80% of children with ADHD will still have symptoms of ADHD when they are adults. Often, the hyperactivity symptoms of ADHD reduce when children get older, but the inattention symptoms often remain.
These videos were created with help of early career scientists of the CoCA project (www.CoCAproject.eu)
It’s October, and that means that it’s ADHD Awareness Month again. Throughout this month people all across the globe will be raising awareness about Attention Deficit Hyperactivity Disorder (ADHD). As ADHD researchers, we of course contribute to this by sharing with you what we know – and what we yet don’t know – about ADHD.
To start off, let’s re-watch the beautiful mini-documentary that was created last year: Shine a light – understanding ADHD. In this video we see several people with ADHD as well as ADHD researchers, who all explain how they see, experience and investigate ADHD.
This year’s ADHD Awareness Month is about myths and facts. On this website you can find some very nice articles that clearly explain the facts: for instance why ADHD is not an excuse for laziness, and why about half of the children with ADHD do not grow out of it when they reach adolescence and adulthood. For this last reason, many of us are studying ADHD in adulthood. For instance in the IMpACT research consortium.
In a few weeks we will be releasing a series of videos in which some more myths about ADHD are being debunked. These videos are being created by researchers from the CoCA-consortium. The research done in this consortium is aimed to stop the spiral from ADHD into depression and obesity, as was written in this nice article by the European Commission.
Another intersting new research theme is whether lifestyle choices such as diet and exercise can influence how we behave and feel. If you want to learn more about this, I refer you the website New Brain Nutrition, which has several very interesting learning modules, as well as a nice blog.
We hope that through these websites we inspire you to learn more about ADHD. Know the facts, and bust the myths!
Brisk/Risks: Go on – what’s the worst that can happen? (15-minute film with BSL) from kaisyngtan on Vimeo. Freeze frame shows participants Jaye Braithwaite with BSL interpreter Jacqui Beckford.
Attention deficit hyperactivity disorder (ADHD) is popularly associated with being easily distracted. Its other features, such as out of the box thinking, hyperfocus or risk-taking seem to be less discussed beyond specialist contexts. Brisk/Risks was a fun, accessible and engaging open mic event exploring risk-taking within and beyond the framework of ADHD and mind wandering. It featured King’s College London’s Professor of Psychiatry Philip Asherson, ADDISS Chief Executive Founder and President of ADHD Europe Andrea Bilbow OBE, and Wellcome Trust-funded medical humanities scholar Dr Sophie Jones, amongst others, and was curated by artist Dr Kai Syng Tan. Brisk/Risks took place on 4 December 2018 at Bush House, London, UK. The event was part of the ‘King’s Artists – New Thinking, New Making’ exhibition, featuring Tan’s exhibition of a large tapestry from #MagicCarpet, which was her project mentored by Asherson (since 2017). The film version of the event (15 minutes) is BSL-interpreted and edited by Studio Maba. The film premiered at Birkbeck Arts Week 2019, which included an exploration by Tan of the contested term of ‘neurodiversity’. In this blog post, Kai shares 2 transcripts from the evening, of presentations by Kai and one of the participants, Jaye Braithwaite, a ‘Creative, Tourettist and Teaching Assistant’. Read Kai’s own reflections on the open-mic and film here.
TRANSCRIPT: Opening provocation by Tan
Do you take risks? Why? Why not? What’s the riskiest thing you’ve ever done? Do you regret it?
Are you risk-adverse? What could be the opposite of risk-seeking? Pragmatism? Common sense? Does survival come into play? Does courage or naivety come into play? Does play and pleasure come into play?
Flip side: Failure? Up-side: Resilience?
Risks and opportunities. Truths or dare. Live fast die young. Crime and Misdemeanours. Health and safety? Sense and sensibility? Cock and bull. A well-known university states: ‘risk-taking produces innovation. That’s why our classrooms are safe spaces for our students to take risks’. Yeah right. We call students ‘clients’ and promise them nothing less than a 2:1. How’s that for innovation?
Seeking novelty, cheap thrills or doing extreme sport because your ADHD brain is under-aroused. Stealing flapjacks from a shop everyday for four years because it gives you a kick — and you didn’t even like flapjacks. Sorry UCL. Having your film banned, tapes confiscated by the government because you’re not allowed to talk politics there. Upheavals: walking out of your family, country, relationships permanent jobs — as the norm, to work on this project for example.
If you have ADHD, your child has 25% chance of also having ADHD – congratulations.
Research commissioned by Eclipse, a black-led theatre company in Sheffield, reveals how when black artists are told that their work is ‘high risk’, it’s ‘simply an excuse for racism’.
Is humanity under threat from the rise of AI? Is democracy dead? — Do we care? Forests are burning. The earth is dying, ice is melting — and we’re put on our bikinis, sunbathing, basking in the heatwave. Heroes like Aung Sun Suu Kyi have fallen. Left standing, on centre-stage, at the far right, are jesters, cowards. Movement, a human right under Article 13 of the Universal Declaration of Human Rights, is endangered. Walls physical and invisible are erected, borders hardened, our minds closed, as we fear the other, retreat to our tribes hide behind screens. We stop taking risks, as artists, scientists, researchers, makers, citizens, and only go for tried and tested options. Work with or fund something/someone unfamiliar? Don’t be silly. We feel impotent, so we punch down, not up. We’re so busy fighting amongst ourselves, that we’ve become what Stephen Fry calls ‘illiberal liberals’ and ‘irrelevant and outdated bystanders’. The masses have shown that they can’t be trusted. So is now the time for a new profound theory, as Slavoj Žižek argues?
What if human beings didn’t go to the moon? What if, 2 million years ago, our ancestors didn’t run long distances — 6 hours, 30 kilometres, after the antelope –to hunt them down? Would the Homo erectus have died of starvation? What if migrants who risk everything to give their kids better lives give up and ‘go home’, as people around them keep telling them for centuries? What if entrepreneurs with ADHD like Richard Branson didn’t risk everything and start their businesses?
What if no one comes to my first ever – and possibly last — open mic? What if people come but no one comes up to speak? Will this spell the end of my career as an artist-curator?
It’s OK. I have a plan B. It’s our secret — that’s why I’m whispering. I’m coming up with my own brands of perfume. It’s targeted at people who think ADHD doesn’t exist. So when they use it, it makes them ‘a little bit more ADHD’: more restless, more reckless.
One is called Impulse. The other? Risk.
Would you buy it?
TRANSCRIPT: Presentation by Jaye Braithwaite
I shouldn’t be hiding
There’s no denying
That I’ve got Tourettes
I tic I shout I move all about
Let’s do adhd next
I can’t keep still
I can’t concentrate
I can’t wait
My mind races
The competition is real
I get that urge to tic …The thought, the feel
Sometimes it’s good
Sometimes it’s bad
Other times I’m happy
Other times I’m sad
The creativity I get
The way it hits me
I feel so free
Writing at 3am
Paper and pen
Ticcing at dawn
Sleeping at noon
It all just happened
Won’t be ending too soon
I like to think
Think think think
Or am I just weird
I used to be angry
But I realised I was Just scared
Scared of people
And how they would react
It would cause me to act
Act normal or whatever that is
These weird things about me I hid
Hid them well
Until my head began to swell
I couldn’t take it anymore
It was time to pour
I’ve got adhd and Tourettes
And I’m allowed
Allowed to be myself
Now I can be
I can be finally free
*See film trailer version of the film Brisk/Risks here.
*See images and feedback of premiere of the film at Birkbeck, University of London, on 21 May 2019 here. The film premiere was part of Too Much/Not Enough: Neurodiversity and Cultural Production, of the Birkbeck Arts Festival, The evening featured 2 new provocations by Kai, alongside medical humanities scholar Dr Sophie A Jones and curator Alessandra Cianetti. Listen to podcast here and read the transcript of Kai’s response to the open mic/film, on risk-taking and leadership, here, and a provocation on the contested term ‘neurodiversity’ here.
The open mic and film are part of ‘We Sat On A Mat and Had a Chat and Made Maps! #MagicCarpet (from 2017), which is an art-science exploration which gathers diverse and divergent bodies (and bodies of knowledge) to explore difference and (neuro)diversity, with ADHD and how it relates to mind wandering as a starting point. #MagicCarpet was a 2017 Unlimited commission funded by Arts Council England, with additional support by King’s College London. Thus far, #MagicCarpet has reached more than 9000 people, including through Arts in Mind and Unlimited Festivals. Venues include Science Museum, Southbank Centre, South London Gallery, Art Workers’ Guild and the Peter Scott Gallery (Lancaster). Publications include an article that was read 2000 times within 2 days of publication in The Conversation (10.6 million readers) and a top 2018 editorial on neurodiversity and women in Disability Arts Online. 100% of the feedback for an event stated that the work has challenged their understanding of how the arts and science can collide and create new insights. AHRC reviewers have described a proposal of next phase of the work as ‘exciting and innovative’; ‘already leading the way’ and ‘with an impressive track record’. #MagicCarpet was awarded a prize for ‘Cultural Change’ by the National Coordinating Centre for Public Engagement (2018). Dr Kai Syng Tan FRSA SFHEA was the project’s lead and the first artist-in-residence at the Social, Genetic & Developmental Psychiatry Centre. An artist, consultant, curator and academic, Tan is best known for gathering diverse and divergent bodies and bodies of knowledge to engineer spaces of ‘productive antagonisms’ (Latham & Tan 2016) across disciplinary, geopolitical and cultural boundaries, in what she calls an interdisciplinary ‘ill-disciplined’ approach (Tan & Asherson 2018). Marked by an ‘eclectic style and cheeky attitude’ (Sydney Morning Herald 2006), ‘radical interdisciplinarity’ (Alan Latham 2016) and ‘positive atmosphere’ (Guardian 2014), she is recognised as ‘absolutely central’ for the emerging ‘Running Studies’, and was Visual & Communications Director for the £4m Opening and Closing Ceremonies of 8th ASEAN Para Games (2015).
Having ADHD is expensive. A study of German insurance data has shown that the medical costs of a person with ADHD are 1500 euro higher per year, compared to a person without ADHD. But that’s not all; individuals with ADHD are far more likely to suffer from additional conditions such as mood and anxiety problems, substance abuse or obesity. Treatment of these conditions can cost up to an additional 2800 euro per year. As ADHD – especially in adults – is still poorly recognised and diagnosed, these numbers may not reflect the complete picture of ADHD medical costs. Improving diagnosis and adult mental healthcare may prevent mental health problems later in life and actually reduce costs, argue Berit Libutzki and her co-authors.
ADHD (Attention Deficit / Hyperactivity Disorder) is a developmental condition. Symptoms arise before the age of 12 and are characterised by age-inappropriate and impairing behaviour in terms of problems with attention, impulsivity and hyperactivity. World-wide prevalence of children with ADHD is estimated around 5%, while in adults this is around 2.5%. This means that in about half of the children problems do not subside with age. For these people, ADHD is a lifelong condition that often impairs health, career and social life.
To estimate the economical costs of ADHD, Berit Libutzki and her colleagues from HGC Healthcare Consultants GmbH analysed the (anonymised) health insurance data of almost four million Germans. They compared the medical costs of people with an ADHD diagnosis to those of a well-matched group without ADHD.
The results showed that the medical costs of a person with ADHD are on average 1508 euro higher than those of a person without ADHD. These costs are mainly due to treatments in hospitals and by psychiatrists. ADHD medication itself (such as Methylphenidate) are in third place, contributing to only 11% of the additional costs. Other interesting findings from the study are that medical costs are a bit higher in women compared to men, and that costs are much higher in individuals over 30 years old compared to younger age groups. After the age of 18, the costs of for example ADHD medication drop, while psychiatrist costs and costs for other (non-ADHD) medications increase notably. Also sick payment is high in adult ADHD patients, leading to a significant increase in costs. One of the explanations for these cost increases could be a gap in care after leaving the regular care of a paediatrician at age 18, and the development of disorders that arise in addition to ADHD.
ADHD plus additional (mental) health problems
It has been shown before that having ADHD puts you at a much higher risk of developing additional (comorbid) disorders. Mood disorders – such as depression – and anxiety are most frequent; in the German data two-thirds of ADHD individuals over 30 had such an additional diagnosis (compared to only a fifth of adults without ADHD). Substance abuse and obesity are more common in people with ADHD as well. These comorbidities should not be underestimated as they add strongly to the burden of disease. The study shows that substance abuse and morbid obesity are even the most costly, especially in adulthood. In total, the surplus costs associated with these conditions are 1420-2715 euro higher for ADHD individuals, compared to individuals who suffer from mood or anxiety disorder, substance abuse, or obesity alone.
Scientists think that certain genetic factors that play a role in ADHD also make a person more vulnerable for these comorbid health conditions. Libutzki and her team are part of the European research consortium Comorbid Conditions of ADHD (CoCA) that investigates the shared biological mechanisms of ADHD and these additional disorders. “Through this research we hope to find leads to prevent these disorders from developing, and improve mental health care.”, says the leader of the CoCA consortium Prof. Dr. Andreas Reif of the University Hospital Frankfurt.
“It is intriguing to speculate that these comorbidities, which were shown to be the important cost drivers in adulthood, could be prevented if mental healthcare were provided more constantly over the lifespan” write the authors. “The prevention of the development of comorbidities with age should be the focus of mental health care. Early treatment starting in childhood and continued treatment of adolescents into adulthood seem therefore advisable.”
Improving diagnosis and adult mental health care
There is one caveat in the study by Libutzki, that is also acknowledged by the authors: many people, especially adults, are not diagnosed with ADHD, even though they experience the symptoms. “Our knowledge gap is especially large in adulthood”, says Dr. Catharina Hartman from the University Medical Centre Groningen, The Netherlands. “The prevalence of adult ADHD in the health insurance data was very low (0.2 %). Given that the population prevalence for adult ADHD is 2,5 %, this indicates that many adults with ADHD are currently not diagnosed or treated. They may nonetheless make high direct costs since their ADHD may not be recognised, or they make indirect costs through unemployment or criminality.” This would indicate that the costs reported by the study are underestimated. On the other hand, adults often find out about their ADHD only after consulting a psychiatrist for other mental health problems. This would indicate that estimated costs and prevalence of comorbid disorders with ADHD in adulthood are overestimated, compared to when you were to include also all undiagnosed people with ADHD, and diagnosed persons who do not make costs (i.e. milder cases of ADHD).
The study thus provides a partial view on the costs of ADHD during the lifespan. That said, it is among the first to show in detail the lifespan medical costs of ADHD and comorbid disorders in Germany. These findings are likely to be representative of other western-European countries. Policy makers in these countries are strongly advised to investigate ways to improve the transition from child to adult mental healthcare and increase awareness about adult ADHD. This will not only improve the quality of life of many adults but may also save money.
Do you have an ADHD-friendly work environment and management?
Can you be trusted by your employee for the disclosure of his/her ADHD?
Are you aware of the professional needs of your neurodiverse employees? – Boss: Is there anything that I’m doing or that anyone else is doing here at work that’s interfering with your success?
Are you incorporating reasonable accommodations (flexible work style/role innovation/closer supervision/reward systems) to create a positive and productive work environment for your neurodiverse employees?
If not, do you think the only solution would be to replace your neurodiverse employee with a neurotypical?
Have you taken or are you willing to take professional trainings for tackling talented but sometimes difficult employees?
Do you figure out your employees’ strengths and form a strength-based approach?
Do you foster a work culture of compliments more than that of complaints?
Would you be open to personally work on the integration of diversity besides having personal sympathy and/or professionally capitalizing on the neuro-developmental disorders?
Do you truly believe that organizational problems of your neurodiverse employees are the outcomes of ADHD and not the grounds for firing them?
With neurodiverse people in your workplace, do you offer training/coaching to support their skills and for the organization to create an inclusive culture?
Can you recognize ADHD (or other diversity) in your workplace?
Most importantly, are you inclined towards being an ADHD-friendly employer and manager?
“I did see my job at risk but could not change anything”
– A freelancer (late thirties), worked for an e-commerce and cloud computing company, double Master’s degrees holder and with ADHD
“I don’t remember failing the deadlines. How? I had to work overtime and give up on my personal interests. The projects I was allocated did not fit my strengths. I wouldn’t say dealing with customers is my biggest strength. Further adding to my misery, I was made responsible for overseas clients which played havoc with my sleep cycle. My continuous requests for switching the duties and departments were never well received. Instead, I came across as a demanding, an arrogant and inflexible person.
I thought I had made a few friends at work but nobody wants to hang out with the boss’ not-so-favorite person. I was given a three-month termination period; I could not utilize it to find myself another job, as I was looping within the company’s projects. It was followed by a stretch of depression, and multiple but feeble psychotherapy sessions.
This was not my first job. I indeed have a 7 year experience (starting in my late twenties) in one of the richest and best known Information Technology multinationals. Looking back, I spent most of my professional life stuck in the office for hours with my laptop, could never actually build networks, and had the uncountable guilt trips of cancelling on friends and family.
How do people with ADHD even get closer to managing both personal and professional life? I am now trying to make a living as a freelancer. It has been two years since that full-time job, but the downers don’t let me re-enter the corporate sector or raise a family of my own. I feel I had wrongly prioritized my entire life by putting the professional part first. I have lost a lifetime.”
“I did not even see it coming!”
– A dietitian (late thirties), parent, worked in academia and with ADHD.
“As an independent professional, I had been doing well. Why I switched to an academic position? I think of myself as a cheerful and people’s person. The idea of working in academic teams was quite fulfilling. I am so intrigued by nearly everything I am a part of.
With a mind full of too many and rational ideas, I can sometimes be challenging for others to work with. I finish the assignments, but with delays; thanks to the perfectionist within me. I spend too much time on perfecting things that at the end everybody is just relieved to get it submitted rather than appreciating the quality. I wish I could “just do it” rather than “doing it right”, and direct my creativity and research habits into the truly rewarding tasks.
At first, everyone seemed to like my company but things suddenly changed one day! My job dismissal – with an immediate effect jolted me. I had naively thought the boss would probably be more supportive after knowing my ADHD and where I was struggling. I loved my work that I was originally hired for but the unsaid overwhelming paperwork!
I have always been a bit clumsy, or much clumsier than the average person. People notice my ineptness, but not the frustration I internalize in those situations, like re-doing documents just because I lost track of originals, or re-booking flights that incur me hefty losses.
Struggling professionally, financially to support myself and kids, I now feel like a juggler.”
Does your mind wander? What do you picture when you daydream? Where do you go? How far is too far? How often is too often? When does mental restlessness become impairment? What are the boundaries between pathology and normalcy, a healthy brain versus one that is ill, disordered and disorderly? What can a science-art collaborative exploration of mind wandering contribute to, challenge and extend our understanding of wellbeing?
Art invades science, science invades art: Phil and Kai at Monologue Dialogue IV exhibition inside Kai’s installation entitled ‘Crossed wor(l)ds (un-floored) (brain drawing) (2019 itinerary) (after Brexit, Chagall, Billingham, Wes, Savage, 2017)’, The Koppel Project, London.
Memory Lane, Institute of Psychiatry, Psychology and Neuroscience, King’s College London
Above: Left: Art invades science, science invades art: Phil and Kai at Monologue Dialogue IV exhibition inside Kai’s installation entitled ‘Crossed wor(l)ds (un-floored) (brain drawing) (2019 itinerary) (after Brexit, Chagall, Billingham, Wes, Savage, 2017)’, The Koppel Project, London (Photography by Richard Wright). Right: Memory Lane, Institute of Psychiatry, Psychology and Neuroscience, King’s College London.
A roving art installation
Drawing on emerging research on how mind wandering relates to Attention Deficit/Hyperactivity Disorder[i], channelling the exuberance of artist Grayson Perry’s legendary tapestries as well as an artist’s lived experience as a mind wandering extraordinaire, We sat on a mat and had a chat and made maps! #MagicCarpet is a new collaboration between artist Dr Kai Syng Tan and molecular psychiatrist Professor Philip Asherson that aims to generate a critical and creative space to explore the boundaries between normal and abnormal behaviour, social and medical models of disability, imagination and pathology, art practice and scientific research, clinician and patient. Under the mentorship of Professor Asherson at the MRC Social, Genetic & Developmental Psychiatry (MRC SGDP) at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), a key aspect of the practice-led research project is how Kai will gate-crash/invade/intrude/immerse herself within the environment of leading researchers in ADHD at King’s College London as a Visiting Researcher. Apart from observing/participating in seminars, Kai will also volunteer for scientific experiments and trials. She will then embed knowledge, questions and interpretations gained in the design of a tapestry. The tapestry will be weaved in Flanders Tapestries in Belgium, which has produced tapestry art by Perry and other contemporary artists. The work ‘takes off’ when people sit on the tapestry, and chat about their mind wandering. Because words may be inadequate or challenging, they also capture their discussions/disagreements/discoveries in the form of maps and drawings (and the point is not how well you draw) that they will co-create. Co-riders of this ‘magic carpet’ include clinicians and researchers from UK Adult ADHD Network (UKAAN), self-taught artists from Submit to Love Studios, of Headway East London, a charity for people affected by brain injury, and as well as students and staff at King’s and elsewhere. Selected maps, as well as commissioned text and developmental sketches, will be documented in a limited-edition publication. A one-day seminar, exhibition and book launch will take place at the iconic Art Workers Guild. Other possible exhibition venues may include the Southbank Centre and IoPPN. Those who cannot experience #MagicCarpet live may enjoy photographs and a short film published on social media.
A space to problematise, debate and make magic
As Flo Mowlem (April 11) and Dr Martine Hoogman (March 20) pointed out in previous blog posts, while mind wandering – in which attention switches from a current task to unrelated thoughts and feelings[ii] – is a universal human experience, excessive mind-wandering can be unproductive, and could be a key feature of ADHD; while ADHD can pose serious problems, there can be positives, and this is hitherto an under-explored area of research. Indeed, as one of the best example of a continuous trait found in both impaired and excelling individuals, ADHD is an ideal springboard to spark a discourse about the line(s) separating wellness and illness. BBC Horizon’s recent ADHD and me with Rory Bremner did a wonderful job in sparking mainstream interest in ADHD (not least in its controversial analogy of people with ADHD as half-baked gingerbread cakes and hapless victims of shark attacks). The ‘magic’ that #MagicCarpet as a project aims for is not to provide answers but to raise more questions. This is not just during the workshops, but publication, exhibition (if the tapestry and maps are portraitures of the makers’ neurodiversity, they present an interesting counterpoint to the hung portraits of able-bodied males that deck the Edwardian Hall of the Art Workers’ Guild), and beyond. While there are no shortage of melting clocks, cupboards that lead to other worlds and grand pronouncements about human beings’ primal desire for ‘journeys of the mind and body’, without which we ‘rot’ [iii] in the so-called ‘art world’, that mind wandering as a subject area, creative process or tool in the arts seems to be an unchallenged ‘given’ makes it an appealing area of research for Kai as a researcher and practitioner. Her own diagnosis of ADHD, dyslexia and dyspraxia in Autumn 2015 generated questions, not clarity. Where and when does the ADHD/art/personality begin, end or smash into each other? What are the problems and opportunities afforded by conceptualising and making ‘neurodiverse art’? Is this discussion a rehash of the tiresome myth of the ‘mad artist/genius’ (which artists themselves may corroborate, intentionally or inadvertently)? Is neuroscience society’s new tool to ‘other’ people who do not conform, or does it enlighten and clarify? What can art bring to this conversation? #MagicCarpet is Kai’s process of inquiry/discovery as a woman/artist/curator/researcher. It is also her way to interrogate existing representation of ADHD which she has found to depict as largely only affecting children or adult male criminals, and only as an aberration to be corrected, cured, ironed out, medicated.
#MagicCarpet may also present a template of how art and science can clash and/or create sparks. As an ‘experiment’ which ‘invites us into the epistemological space of the laboratory’ while pointing to ‘ethical and aesthetic territories of novelty, invention, and play’[iv], it contributes to discourses on interdisciplinarity. Research in and with the arts and sciences tends to be siloed, but grand (and not-so-grand) challenges often require crossovers and the pushing of boundaries. The work creates a platform for clinical communities to dialogue with the arts about ADHD. As a leading artist working in the art-science interface argues, ‘not only is medicine capable of providing new material for the gallery space’, art can bring ‘new knowledge into the consulting space’ [v]. Equally important is the opportunity for artists to engineer forays out of comfort zones, in order to learn unfamiliar tools, languages and processes. A mind that does not seek new frontiers is one that is closed and stuck. Kai is thrilled as she is terrified by the extent to which her trespass into the medical world disrupts her assumptions and habits as an artist. Which was why she approached Philip in March 2016. The ensuing cultural clashes, collisions and antagonisms would, hopefully, be jarring, surprising, productive [vi].
Unlimited commission, unlimited possibilities
#MagicCarpet is one of 6 works commissioned by Unlimited in its Main Commissions strand for its 2017 round of awards. Unlimited is an arts commissioning programme that celebrates the work of disabled artists, with funding from Arts Council England, and is delivered by Shape Arts and Artsadmin. While the project is expected to run between Summer 2017 – Autumn 2018, there are possibilities to extend #MagicCarpet intellectually, artistically, pedagogically. An example is to tour the tapestry at various universities and working with the respective disability offices to help raise awareness of ADHD, mindfulness and neurodiversity in its staff and student populations. Another is to incorporate the tapestry as an object-based learning activity for students at MRC SGDP. Evidence relating ADHD with exercise as a preventative treatment is emerging[vii]. This is an area that could be developed into a research project, and relates to Kai’s existing body of work on running as a creative and critical toolkit. A related strand is to work with mobile EEG devices to enable the ADHD brain to create ‘brain drawings’ as the body runs through different places in various parts of the world, which could fit under the Science in Culture flagship of the Arts and Humanities Research Council.
Come ride the magic carpet with us. Share your thoughts, experiments, explorations, recommendations and counterarguments. Let’s see how far we can go (together).
Dr Kai Syng Tan FRSA SFHEA is an artist and curator. Through installation, performance, film, and text, she explores the body and mind in (com)motion. Sitting/slipping between/beyond discipline/form/conceptual frameworks/spaces/places/allegiances, her work is turbocharged by a day-glo palette, hyperactive layering and over-the-top vocabulary. They have appeared at Documenta, Royal Geographical Society, Biennale of Sydney, MOMA, BBC and the Guardian, and are collected by the Museum of London and Fukuoka Art Museum. Currently a Research Fellow at Leeds College of Art, Visiting Fellow at University College London’s Institute of Advanced Studies, Peer Review College Member of the Arts and Humanities Research Council and Director of RUN! RUN! RUN! International Body for Research, Kai completed her PhD at the Slade School of Fine Art, University College London. From Summer 2017 she will also be a Visiting Researcher at SGDP. @kaisyngtan
Professor Philip Asherson, MB,BS, MRCPsych, PhD is Professor of Molecular Psychiatry at the MRC Social, Genetic and Developmental Psychiatry (SGDP) centre at the Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London in the United Kingdom. Since 1996 when he moved to the IoPPN he has worked closely with Professor Jonna Kuntsi to develop a program of research on clinical, quantitative and molecular genetics of ADHD. In his own work, he has a particular focus on adults with ADHD. Current research projects include investigations of the neural basis of mind wandering in ADHD, clinical trials of prisoners with ADHD, and the impact of ADHD on learning in University students. He is the author and co-author of more than 300 articles and book chapters on ADHD and other neurodevelopmental disorders and traits. @ukaan_org
[i] See for instance Franklin, Michael S., Michael D. Mrazek, Craig L. Anderson, Charlotte Johnston, Jonathan Smallwood, Alan Kingstone, and Jonathan W. Schooler. “Tracking Distraction.” Journal of Attention Disorders 21 (6): 475–86. doi:10.1177/1087054714543494 (2014) and Mowlem, Florence D., Caroline Skirrow, Peter Reid, Stefanos Maltezos, Simrit K. Nijjar, Andrew Merwood, Edward Barker, Ruth Cooper, Jonna Kuntsi, and Philip Asherson. “Validation of the Mind Excessively Wandering Scale and the Relationship of Mind Wandering to Impairment in Adult ADHD.” Journal of Attention Disorders, June, 1087054716651927. doi:10.1177/1087054716651927. (2016).
[ii] Smallwood, Jonathan, and Jonathan W. Schooler. “The Science of Mind Wandering: Empirically Navigating the Stream of Consciousness.” Annual Review of Psychology 66 (January): 487–518. doi:10.1146/annurev-psych-010814-015331. (2015).
[iii] Chatwin, B. Anatomy of Restlessness: Selected Writings 1969-1989. Viking Pr. 100-106 (1996).
[iv] Callard, F, and Fitzgerald, D. “Medical Humanities.” Where Does It Hurt, 16–17 (2014).
[v] Padfield, D. MASK: MIRROR: MEMBRANE The photograph as a mediating space in clinical and creative pain encounters. University College London. 3 (2013).
[vi] Elsewhere Kai has talked about interdisciplinary collaborations. See Latham, Alan, and Kai Syng Tan. “Running into Each Other: Run! Run! Run! A Festival and a Collaboration.” Cultural Geographies, Cultural Geographies (Sage), doi:10.1177/1474474017702511 (2016).
[vii] Rommel, Anna-Sophie, Jeffrey M. Halperin, Jonathan Mill, Philip Asherson, and Jonna Kuntsi. “Protection from Genetic Diathesis in Attention-Deficit/hyperactivity Disorder: Possible Complementary Roles of Exercise.” Journal of the American Academy of Child and Adolescent Psychiatry 52 (9): 900–910. doi:10.1016/j.jaac.2013.05.018. (2013).