Risk-taking and ADHD?

Posted on by kaisyngtan

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.

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Andrea Bilbow OBE with BSL interpreter Jacqui Beckford. Photograph by Alessandra Cianetti.

 

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?

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Some of the comments for the evening.

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

Absolutely

Disorganised

Happily

Daydreaming

 

I can’t keep still

I can’t concentrate

Easily distracted

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’m unique

So unique

 

I like to think

Think think think

 

I’m unique

I’m special

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

Show myself

Be proud

I’ve got adhd and Tourettes

 

And I’m allowed

Allowed to be myself

No filter

Just me

Now I can be

I can be finally free

 

—

 

LINKS

*See film trailer version of the film Brisk/Risks here.

*See gallery and feedback of 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.

* Find out more about #MagicCarpet here

* The Conversation article by Tan and Asherson: On the salience of high quality art in mental health

*BMJ medical humanities article: On thought-leadership of arts & philosophy inculture change (review of Mohammed Rashed’s book on mad activism)

*Disability Arts Online article: On neurodiversity & women

*PsychART article: On #ADHD women making #ADHD art

*A-N Artists’ Information article: On mind wandering: Best Friend/Worst enemy

*KCL Culture story: On being the first artist-in-residence, Social, Genetic & Developmental Psychiatry Centre

ABOUT #MAGICCARPET

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).

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Audiences, including Professor Philip Asherson in the front row, enjoying the open mic. 4 December 2018, Bush House, London, UK.

 

Can virtual reality help in the treatment of ADHD?

Posted on by isabella.vainieri

Virtual-reality (VR) can be defined as an interactive computer-generated experience that can be similar to the real world or fantastical1. For instance, in a VR environment, a person is able to virtually live in the artificial world by looking and moving around it, as well as interacting with virtual characters or items2. Nowadays there are different kinds of VR environments, mainly used for entertainment purposes (e.g. video-games) or professional training (e.g. aviation, military training etc.)3. VR tools usually  range from a headset  (head-mounted displays with a small screens in front of the eyes), to proper full-scale rooms with bigger screens and special equipment  to increase the augmented reality experience.

Virtual reality head-mounted display. Image by Gerd Altmann from Pixabay.

VR has been recently investigated as a potential treatment for different metal health problems or psychiatric disorders such as social anxiety4, specific phobias5, post-traumatic stress disorder (PTSD)6, or persecutory delusions7. The key assumption behind the use of VR tools in mental health practice, relies in the fact that, in VR settings, individuals can repeatedly experience and learn appropriate coping strategies in a controlled environment8,9. For instance, knowing that the exposure is not real, allows people to face difficult situations and learn therapeutic strategies which they can then adopt in the real world.

..but how those VR tools can be used for the treatment of ADHD?

Recent evidence shows that VR can help enhance some of the core therapeutic challenges of ADHD such as attention, problem solving and managing impulsive behaviours10. For example, using VR can create virtual scenarios that can reward and empower skills such as response inhibition and emotional control10. One of the most commonly used scenarios is the class-room environment, which can introduce life-like distractions to asses children’s behaviour in an ecologically-based setting 10-11. In this virtual environment children with ADHD may be more able to use the trial-and-error instructional strategies to train learning skills11. For instance, in these VR settings, children with ADHD can also learn strategies to use in the real world without experiencing failures due to their experiences at school, making them more willing to accept the private feedback of the VR teacher.

Although VR ca be potentially used in ADHD treatment, is still an experimental procedure that needs more research to assess its validity. Also, there are still some concerns regarding potential side effects of long-term VR exposure, such as headaches, seizures, nausea, fatigue, drowsiness, disorientation, apathy, and dizziness10. Overall, despite its therapeutic potential, more studies are needed to assess its long-term treatment efficacy as well as the efficacy of VR environments compared to other non-pharmacological treatments already available for ADHD.

Isabella Vainieri and Jonna Kuntsi

Isabella Vainieri is a PhD student at the Social, Genetic & Developmental Psychiatry Centre at King’s College London.

Jonna Kuntsi is Professor of Developmental Disorders and Neuropsychiatry at King’s College London.

References

  1. Burdea, Grigore C. and Philippe Coiffet. Virtual Reality Technology. John Wiley & Sons, 2017.
  2. Rizzo AA, Buckwalter JG, Neumann U. Virtual reality and cognitive rehabilitation: a brief review of the future. J Head Trauma Rehabil. 1997;12:1–15.
  3. Johnson D. Virtual environments in army aviation training; Proceedings of the 8th Annual Training Technology Technical Group Meeting; Mountain View (CA), USA. 1994.
  4. . Maples-Keller JL, Bunnell BE, Kim SJ, Rothbaum BO. The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders. Harv Rev Psychiatry. 2017;25(3):103–113.
  5. Roy S, Kavitha R. Virtual Reality Treatments for Specific Phobias: A Review. Orient.J. Comp. Sci. and Technol;10(1).
  6. Rizzo A’, Shilling R. Clinical Virtual Reality tools to advance the prevention, assessment, and treatment of PTSD. Eur J Psychotraumatol. 2017;8(sup5):1414560. Published 2017 Jan 16. doi:10.1080/20008198.2017.1414560
  7. Freeman, D., Bradley, J., Antley, A., Bourke, E., DeWeever, N., Evans, N., Černis, E., Sheaves, B., Waite, F., Dunn, G., Slater, M., & Clark, D. (2016). Virtual reality in the treatment of persecutory delusions. British Journal of Psychiatry, 209, 62-67.
  8. Sanchez-Vives M, Slater M. From presence to consciousness through virtual reality. Nat Rev Neurosci 2005; 6: 332–9
  9. Slater M, Rovira A, Southern R, Swapp D, Zhang J, Campbell C, et al. Bystander responses to a violent incident in an immersive virtual environment. PLoS One 2013; 8: e52766.
  10. Bashiri A, Ghazisaeedi M, Shahmoradi L. The opportunities of virtual reality in the rehabilitation of children with attention deficit hyperactivity disorder: a literature review. Korean J Pediatr. 2017;60(11):337–343.
  11. Bioulac S, Lallemand S, Rizzo A, Philip P, Fabrigoule C, Bouvard MP. Impact of time on task on ADHD patient’s performances in a virtual classroom. Eur J Paediatr Neurol. 2012;16:514–521