ADHD Experience and Diagnosis: A Societal Perspective

Theoretical Support

My theoretical foundation is “rhizomatic” and weaves through a framework of feminist disability studies, feminist science, technology, and society studies, neurodiversity, education policy, and agnotology. While I do not go deeply into agnotology, elucidated as “a missing term to describe the cultural production of ignorance (and its study)” and coined by Robert Proctor, a professor in the history of science and technology at Stanford, my study is fueled by questions of why don’t we know what we don’t know (Proctor, 1)? Why are some people not diagnosed with ADHD as opposed to others? The thinking behind Agnotology as explained by Robert Proctor and Londa Schiebinger is, “a great deal of attention has been given to epistemology (the study of how we know) when “how or why we don’t know” is often just as important, usually far more scandalous, and remarkably under theorized” (vii). My intent is to look for what is under theorized, absent, or invisible, in the field of ADHD, with respect to the experiences and diagnosis in under represented demographics. The “ignorance pie” according to Proctor, is divided into three large slices: “Ignorance as native state or (resource), ignorance as lost realm (or selective choice), and ignorance as a deliberately engineered and strategic ploy (or active construct)” (3). With respect to knowledge formations surrounding AD(H)D, I am mainly attentive to “ignorance as a lost realm, or selective choice (or passive construct), wherein knowledge and ignorance have a “political geography” as in “who knows,” who doesn’t and “why not?” (6). Proctor shines a light on inquiry being selective: ”we have a predator’s fovea (versus the indiscriminate watchfulness of prey), and the decision to focus on this is therefore invariably a choice to ignore that” (7). 

This notion that the framework decides what we see reveals itself in Sandra Harding’s thought "bodies of systemic ignorance always develop alongside bodies of systematic knowledge, since asking one kind of question about natural or social relations can cognitively, technically, or simply pragmatically preclude at that time and place asking certain other kinds of questions" (qtd. in Einstein, 169). Harding, the author of The Science Question in Feminism was one of the few feminist philosophers of science who explored the idea of gendered nature of science as well as the “practical and intellectual problem that science presented for feminism” in the eighties (Connell, 536). Harding is also a proponent of the notion of “strong objectivity,” a conception that “requires that the subject of knowledge be placed on the same critical, causal plane as the objects of knowledge” (Harding, 458). She goes on to emphasize, it “locates the assumed difference between subject and object of knowledge in social history.” This approach can be achieved through “standpoint epistemology” that erases hierarchy and tries to raise questions “from the perspectives of marginal lives” (McHugh, 56). A discussion of Harding’s “strong objectivity” necessitates a nod to its partner theory, and another theoretical pillar of support in my research, feminist biologist Donna Haraway’s “situated knowledges.” 

Haraway’s questioning of objectivity and claims of how knowledge is created form the bedrock of my research. Similar to Harding, Haraway refutes notions of ‘scientific’ objectivity, as we think about it—impersonal, logical, and overarching—and claims, “we unmasked the doctrines of objectivity because they threatened our budding sense of collective historical objectivity and agency and our “embodied” accounts of truth” (578). She further ties the creation of knowledge with visualization, perspective and positionality, and questions of who does the seeing and with whom: 
 
I want a feminist writing of the body that metaphorically emphasizes vision again, because we need to reclaim that sense to find our way through all the visualizing tricks and powers of modern sciences and technologies that have transformed the objectivity debates. We need to learn in our bodies, endowed with primate color and stereoscopic vision, how to attach the objective to our theoretical and political scanners in order to name where we are and are not, in dimensions of mental and physical space we hardly know how to name (582). 

She argues against “disembodied” objectivity and the over-arching, sweeping vision in scientific practice she calls the “god trick” (Haraway, 581). The questions of perspective and positionality, strong objectivity, and situated knowledges become vital to my research when one starts to investigate, who is diagnosing, and how? How is that vision limited or enabled? As Haraway notes, “feminist objectivity is about limited location and situated knowledge, not about transcendence and splitting of subject and object. It allows us to become answerable for what we learn how to see” (583). 

Thus, in order to stay true to feminist, strong objectivity approaches, I chose in-depth, ethnographic interviews as one of my research methods, as well as principles of participatory action research to engage with the school community, keeping in mind critical psychologist’s criteria for “'feminist objectivity': inscription, micropolitics and difference” (Bhavnani qtd. in Camic et. al, 178). Bhavnani uses inscription to “hold herself accountable to produce stories about young women and men that counter—and do not reinforce—dominant , stereotypic scripts,” something I hope to have achieved in this research, micropolitics to “analyze her relation to and with “subjects of her research,” and “difference” to remind her that she must theorize not only the strong trends that sweep across her data, but interrogate, as well and with equal rigor, the subtle and significant 'differences” within' (178).

Next, my theoretical lens is influenced by interpretative and genealogical debates as frames by Kathy Ferguson in The Man Question: Visions of Subjectivity in Feminist Theory. Ferguson says, "interpretation and genealogy are contrasting voices that create different, albeit related possibilities for knowledge and politics" (6). Explaining interpretative theoretical practices, she says that in the "hermeneutical project" the "task of theory is to interpret appearances properly in order to uncover an underlying meaning, a reality distorted but not destroyed by the power of those able to construct the appearances in the first place" (6). Whereas, “political theory's genealogical project deconstructs meaning claims in order to look for the modes of power they carry and force open a space for the emergence of counter-meaning” (6). This weaving between two aspects of feminist theory becomes important as I try to parse “underlying meanings” and relationships in the circulation of AD(H)D but at the same time try and understand how AD(H)D operates as “a function of discourse; what position does it occupy; what functions does it exhibit; and what rules does it follow in each type of discourse.” Specifically, Ferguson elaborates, “genealogy takes the modern subject as data to be accounted for, rather than as a source of privileged accounts of the world." (14-15).

When working with the school district, the interpretative project seemed best, as "politically, the interpretative project allows its practitioners to criticize the current situation in light of future possibilities and to ground their recommended actions on their claims to knowledge” (24). However, while presenting to the academy, the genealogical posture seemed best as the latter “sees the search for liberation as itself participatory in the will to truth, or the will to power over truth, and more modestly seeks to unsettle the settled contours of knowledge and power, to make way for disunities and misfits, to let difference be” (24). Ferguson traces disruption of established power in both processes but in diverse ways: “interpretation subverts the status quo in the service of a different order, while genealogy shakes up the orderedness of things” (24). In sum, the interpretivist holds up for us a powerful vision of how things should be, while the genealogist more cautiously reminds us that things could be other than they are" (24).

Furthermore, this study is cognizant of Adam Rafalovich’s claim, a sociologist and author of Framing ADHD Children: A Critical Examination of the History, Discourse, and Everyday Experience of Attention Deficit/Hyperactivity Disorder, that, “as the social product” of discursive formations, diagnoses of ADHD and other mental disorders are always in a state of flux, always contested and contestable” (7). He suggests that “It (ADHD) should not be regarded as a falsehood or, conversely, as a medical reality,” claiming that such a viewpoint is “unsuitable for those determined to debunk medical practitioners, or, conversely those who wish to champion the cause of modern medicine” (9). Instead, he asserts, “one of the goals of genealogical perspective is to step outside of the “either/or” etiological debate and objectify the debate itself or, more specifically to objectify the parts of the debate” (9). Rafalovich advises, “instead of proposing an ontology of ADHD, it would be more pertinent to examine the discourse that has constituted ADHD as an object in the same spirit as Michel Foucault’s genealogical studies” (9). Through researching life stories and drawing on participants’ narratives and juxtaposing those narratives with education structures, medical knowledge and feminist disability studies, this essay, develops a feminist discursive ethnography of the cultural formations of ADHD and traces “threads that weave around and chafe” interpretative and genealogical frameworks. (Ferguson, 9). I also lean heavily on Claudia Malacrida’s post-structuralist analysis of ADHD and interactions and complexities between mothers and professionals, in her book Cold Comfort. Following Malacrida’s lead, I attempt to navigate the research data through Foucault’s “technologies of self” and try and understand “how individuals come to desire and participate in discursive effects that make certain illnesses and their accompanying disciplinary practices operate as though real” (4). 

In addition, I seek to respond to the call of feminist disability studies to try and “close the gap between the subjective experience of illness”—in this case neurological difference—“and the unequal relations of power in which,” affected people “are embedded” (Jung, 264). In the process, I hope to promote a “universalizing view” of ADHD, instead of the prevalent “minoritizing view” (Eve Sedgwick, quoted in Garland, 17).

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