ADHD, Conscientiousness and Will Power

Online debates about ADHD often devolve into a standoff between those sharing their struggles and skeptics dismissing it all as excuse-making. If you struggle with ADHD related issues, this accusation can seem cruel and frankly, demonstrably false. But those who suffer from issues of executive dysfunction, should take a page from their critics, for their own sake. In this piece, I will argue that while talking to yourself, people diagnosed with ADHD are better off thinking of themselves as exhibiting low conscientiousness than being afflicted by ADHD. I’m not confident that this is how you should introduce yourself to your boss, but do think it’s likely to produce better outcomes for the thinker of these thoughts than believing otherwise.

The “low conscientiousness” label might seem excessively harsh so let me clarify what I don’t mean. I’m not claiming that this low conscientiousness is simply a result of not “wanting” to change, or that one can will themselves into behaving otherwise on a whim. After all, most personality traits are somewhat heritable too so there certainly are dimensions of human behavior that are quite hard, if not impossible, to effectively change. I’m also not claiming that ADHD is literally one end point on the spectrum of conscientiousness, such that being diagnosed with it implies low scores on every dimension (facet) of conscientiousness.

I am instead asking people with ADHD to consider adopting a posture towards their ADHD that the phrase “low conscientiousness” triggers at an intuitive level; one that recognizes some performance gap in one’s fulfillment of duties — towards others —but also towards one’s “higher self”. This posture has a two essential ingredients: the recognition of some imperative to change sub-optimal behavior and the attribution of agency to oneself to make desired changes

The Spectrum of Agency

Think about conditions along a spectrum of their responsiveness to incentives. A brain tumor causing memory loss won't respond differently whether you offer the patient a million dollars or not. Similarly, severe schizophrenia typically won't improve through incentives alone - you can't reliably talk or motivate someone out of a psychotic episode. But ADHD sits in a more ambiguous space: while pharmacological interventions often turn out to be the best path forward for many with the condition, one’s behavioral outcomes can be significantly shaped by incentives, beliefs, and systems that are mediated via the conscious self.

Here's a personal anecdote to exemplify this. When I watch TV with my partner, I periodically zone out. I will then proceed to ask an innocent question that lets her know I’ve totally missed the last few minutes of the plot (even while watching shows I genuinely find interesting). My incredibly patient girlfriend occasionally shows frustration, which sometimes successfully motivates me to pay closer attention.

This is evidence that I could have paid attention if I wanted to, right? But the words "could have" is doing a lot of work here. Did I not want to watch the show I myself chose? Was it in my interest to waste time with half-formed thoughts about nothing? Obviously not, but paradoxically, different external conditions and incentives could have evoked different responses from my attentional system.

Samuel Hammond has an excellent piece Putting the “akrasia” in ADHD where he lays it out as such:

If you know you shouldn’t eat another donut but do so anyway, an economist would call that your “demonstrated preference.” You only think you have a preference for calorie cutting, but actions speak louder than words.

Focusing on demonstrated rather than stated preferences is a good rule of thumb for sniffing out bullshitters, but the Socratic / economistic view still leaves something out. Higher and lower order preferences really do exist. And it’s also not solely for lack of willpower that some people seem worse at aligning their actions to their aspirations. They often simply lack the social scaffolding and “choice architectures” that makes doing the good thing easy. This is why people join spin classes or set out their running clothes before bed. Having peers that egg you on and an environment structured to reduce frictions to good behavior are ways your brain, in a period of high willpower, conspires against your brain in its periods of low willpower.

Habits, Systems and Stimulants

It thus makes total sense that ADHD communities and support groups focus a lot on systems and habits. Systems and habits are mechanisms that work by altering at least one of two variables: effort required and expected payoff. Here’s an example that’s accessible to those without ADHD too: If you wake up and wear your workout clothes for the rest of the day, what you’ve done is basically reduce the effort required to take the action of leaving your home for a workout. If you make it a point to stop by your favorite cafe to get a cold brew before your work out, what you’re doing is increasing the expected payoff of taking that same action.

External rewards and systems are one piece of the puzzle. But they still have to be processed through one’s cognitive machinery. The initial values for “effort required” and "expected payoff”, both loosely defined, likely exhibit broad variance across individuals, such that such systems and habits have varying likelihood of success. Subjectively, this is the gap that stimulant medication seems to fill. When one first gets on stimulant medication, staying focussed on a task requires much less effort. It also increases the payoff from the most mundane of activities— like cleaning the kitchen — which granted, don’t seem imbued with profundity, but for once seem to offer the promise of unadulterated accomplishment.

It is thus natural for those diagnosed as adults to feel an exhilarating sense of relief. Often, our experience has been one of living with a deep sense of something being just not quite right, or one of self-flagellation for not trying hard enough, only to repeatedly fail. It can be a relief to externalize some of that, and to recognize, not just intellectually but viscerally, that libertarian free will is an illusion. The message that one tends to take away is the following: “I tried the brute force approach all my life and it didn’t work. Now that I’m medicated, I am able to function so much better. Clearly, this is a condition that I suffer from, not something I was doing to myself”

This takeaway is not far from accurate and yet it runs the risk of missing something important. Here’s my layperson’s model of what has happened to such a person thus far:

There exists variance in how our neurobiological circuits are initially wired, making executive function easier or harder for some people. If executive function is difficult for you, you develop coping mechanisms. Often this involves avoiding activities that make you feel incompetent and where negative feedback is likely. This creates a self-reinforcing loop – you get less practice with tasks where you actually need more practice than average just to function normally.

This cycle of avoidance is likely sub-conscious so the belief that your conscious self had little control isn’t far from the truth. However, it’s a mistake to infer from this, however subtly, that therefore the conscious part of you has no role to play in driving the likelihood of your future success with respect to managing the symptoms of your condition. Of course, no one seriously disputes that the conscious part of you still needs to get your medication, set up systems and actually do stuff at work and home. But the “will-ing” part of your conscious self, that can suppress your lower self’s desires and act conscientiously, that piece of you is still important, even if it has seemingly failed to get you what you want in the past.

Why? Because not all problems are bottlenecked by the same thing and some problems happen to be bottlenecked by will power. If I wanted to play chess at the highest levels, I'm bottlenecked by innate cognitive capacity - no amount of effort would bridge that gap (Apparently I offended folks over at Hacker News by assuming that IQ is real, so I chose a self-deprecating example this time but I will never stop trying to IQ pill y’all). For someone struggling to wake up early, the bottleneck is habit, not moment-to-moment willpower. Without an external stressor like an important interview at 9 am, no amount of mental conviction the night before will override your half-conscious morning self. Success requires systems - perhaps an alarm that forces you to solve complex math problems before snoozing.

Bottlenecked by Willpower

But some struggles, particularly with ADHD, are directly bottlenecked by willpower, which has two components: desire of your higher self to do something and the ability to make your lower self comply with your higher self in the moment. Consider tardiness, a trait associated with ADHD. Being late is the behavioral outcome of several causes and conditions — maybe some distorted time perception, poor habits around planning and time management but also…. poor impulse control. Some of you might relate to the experience of knowing where you need to be in an hour, knowing it would be best to leave right away, but still sort of ‘choosing’ not to. This is a situation bottlenecked by will power.

I acknowledge that subjectively, it might not feel a lot like “choosing”. You weren’t literally thinking to yourself “Fuck it, I just don’t value that person’s time so I’ll show up late”. Perhaps your brain came up with rationalizations about how you could still make it on time if you left ten mins later, or you just sat there feeling sort of fuzzy brained, fully aware that you should leave but just unable to. In that very moment, you could just walk to your closet, put on your jacket and walk out the door. You’re exceptionally unlikely to fail at the execution if you attempt it. But your brain tells you that you cannot. One way to think about this is that your brain is simply relaying some information about past statistics — “when you feel this way, you don’t usually take action”. But the conscious part of us can interpret this message in two equally plausible ways - (1) “Fuck, I’m doomed to sit on the couch” (2) “Yes, but that’s because I don’t act when I feel this way and I could just change that, starting now.”

Paradoxically, being able to consistently choose the second interpretation requires practice. Will power needs to be cultivated. The subjective experience of exercising will power is easier for some people than others. But it’s incorrect to draw the conclusion that if it seems subjectively hard, it must be because effort can’t change that. It’s true that some types of “effort” have no impact, or may even make things worse. Ruminating about how you have low levels of will power falls in this category of unhelpful actions. It’s also useless to try and apply will power to solve big problems in your life at a macro level.

The place to train will power is at the ‘microscopic’ level of taking the smallest of and simplest of actions. Should I open the tab or attempt to keep writing, even though the words don’t seem to flow. Should I leave for the party or continue to sit on my couch for five more minutes? Cultivating will power probably looks like the practice of doing the necessary thing as soon as your conscious brain becomes aware of the fact that there is a choice, and doing it without much further thought.

This brings us recursively back to either increasing the payoff from exercising will power or decreasing the effort required to do so. As for the latter - sleep, nutrition, contemplative practises - can all probably help. But as you might notice, getting better at each of these requires will power too.

The payoff piece of will power is more interesting to me. We need some way to feel good about ourselves for exercising will power. This is only possible if we recognize and internalize the value of will power. As a result, intellectually obscuring its role or diminishing its importance, as I have done myself, can be soothing but ultimately counterproductive. The belief that you can act and that it’s good to act is literally the easiest and hardest step of the process. Once you believe that, there is a payoff waiting when you do the hard thing. And each hard thing you do is an additional data point that builds trust with yourself.

Conclusion

I hate that I have to say this but I’ll do it anyway. Choosing a career you don’t enjoy, a workout that you hate or a partner you dislike are all stupendously stupid ways of “training will power”. Life is hard as is, there is no need to make life choices that make you miserable, so you can train your will power, so you can be happy. As I alluded to in my last post, I believe in only addressing weaknesses that absolutely need to be addressed while mostly leveraging one’s strengths. But within that project, will power is a functional skill that comes in handy, so you can lead a much better life in aggregate.

It would seem like we’ve come a long way from ADHD and low conscientiousness. But recognizing your own agency in your own dysfunction is central to even wanting to analyze and act on any of this. “It’s my ADHD” is too convenient an answer. It’s a fine explanation for how you got here but it’s not a deterministic force that condemns you — unless you really believe it is.