The Univocity of Attention: ADHD and the Case for a Renewed Self-Advocacy

This dissertation uses multi-sited ethnography and socio-philosophical analysis to answer the following questions: What is the current state of ADHD’s onto-epistemological status in contemporary discourse? Is an equivalent to critical autism studies possible for ADHD? Specifically, is it possible to refigure ADHD’s ontology as an affirmative difference rather than a deficit? Drawing from my own experiences living with ADHD, as well as anecdotal and ethnographic accounts from my engagement with ADHD self-advocacy communities, I put various critical social scientific theories “to the test,” including Hacking’s looping effects, structuralist-functionalist’s medicalization and social control, Foucault’s and Rose’s theories of subjectification and governmentality, Deleuze and Guattari’s concept of becoming, the fold and related antipsychiatry approaches (e.g., in mad studies literature), and historical materialist theories of the pathologies of late-stage capitalism. My findings indicate that there is something specific about ADHD’s symptoms that pushes back against the often-totalizing nature of these critical theories. I also draw from science and technology studies to conduct an ethnographic study of an ADHD clinic in Japan, to explore how this specificity of ADHD “travels” in cross-cultural contexts without being reduced to biology or culture. The results of my research indicate that the ontological legitimacy of ADHD (what qualifies it as existing, and what it means for it to exist) in contemporary discourse has little to do with its purported neurobiological or genetic underpinnings. Instead, popular ontological beliefs appear to “swing” between two poles of what I call the “dialectic of medicalization”: in one direction, a belief in the ontological primacy of identity (a disease entity, human kind, brain type, medical label, and so on); in the other direction, a belief in the ontological primacy of individual variation (neurobiological diversity, “human distress,” statistically-associated symptoms, genetic correlates, and so on). I show how this dialectic keeps ADHD in conceptual purgatory, helps to explain the history and current state of ADHD discourse, and contributes to ADHD misrecognition and harm. Borrowing from Deleuze’s Difference & Repetition (1994), I call for a renewed ADHD self-advocacy that breaks free from this dialectic by reformulating ontologies of ADHD in terms of its “difference in itself.” My dissertation arrives at a position compatible with critical disability studies and critical autism studies, though in a way that speaks to the specificity of ADHD’s affirmative differences rather than reducing them to the generality of neurodiversity.