The Real Attention Deficit Disorder


If you’ve spent any time around children, you can probably hear in your mind various versions of pleas for attention. Whether you find it annoying or adorable, you probably don’t criticize the kid for asking. We all take for granted that young humans need attention, even those of us who don’t necessarily want to give it to them. But when it comes to adults, even though nothing has changed in terms of the need, we give each other an almost directly opposite response. I say ‘almost’ because the true opposite would be assuming adults no longer need attention, that attention is like training wheels or Huggies — temporary support as children grow up and learn.

It would be damaging enough if this is where our culture stopped. But what our culture does makes this assumption look like a mild-mannered misunderstanding or miscalculation — like oops, I forgot to carry the one when I multiplied these numbers together. But we don’t forget to ‘carry the one,’ do we? Our culture intentionally singles out the one, shames the one for being just one, points at it like something must be wrong with it for not being two or three or four or more. It’s not that our culture ignores people who are already alone, though that wouldn’t be less painful than what it actually does, which is withhold attention from someone seeking attention precisely because they’re seeking attention. Unfortunately, it’s not just the culture — those of us with lived experience perpetuate this attention-shaming tendency, much like we, often unknowingly or unwittingly, use oppressive language.

“Oh, they just want attention” and its variations are common even among those of us “in the movement.” In fact, therapists, psychiatrists and other providers are all too happy to respond to distress. Ignoring people or shaming people who just want attention rather than finding a way to meet their needs compassionately and safely exposes them to mainstream treatment modalities, health risks, deepening judgments and alienation both internal and external, and possibly (more and more likely) police activity. If we aren’t going to be kind to our own, there is very little incentive for any of the power structures to do so. If we aren’t going to respond in ways different than the culture, we cannot expect to change much that desperately needs changing. If we aren’t going to model how the human need for attention should be met, especially in times of suicidal despair (which is traumatizing to experience; you have my word on that), there is no reason to suspect that the damage being done by the current mental health system and the culture at large will cease.

Why is it that when people express lethal despair, they are almost always accused of “just wanting attention?” First of all, it would only make sense that suicidal people would want attention. It’s not a requirement of experiencing suicidal thoughts, of course, but there’s also nothing wrong with wanting attention and connection with other people when you’re struggling with life and death. Beyond that, though, what is the logic behind ignoring people who want attention? People can, of course, be manipulative and say things they don’t mean in order to get attention. But what’s wrong with wanting attention? Living in a society that permits punishing people for having fundamental needs (like attention) is probably one of the reasons people have developed behaviors “just” to “get attention.”

People seek attention for a reason. And that reason is that, as ugly as we can be to each other, and as alone as we are convinced we would like to be (myself included), I believe the research (here and here and here, as well as a rapidly growing number of other places — including a traditional psychiatrist who talks about our adaptive, biological need for connection, which involves attention from others) that says we actually do need each other, both to develop properly — the brains of children who have been extremely emotionally neglected are smaller than children of the same age who have received appropriate attention and affection — and to remain healthy. The basic need for attention, attachment, affection, does not change just because our bodies do.

Speaking of bodies, they can provide a useful illustration that basic needs, while they may change, don’t go away. Our bodies have receptors that remind us of every biological need as they arise. A large part of the crisis work I do in a city that has no political will to do a damn thing about the housing crisis is to help people stabilize by meeting their basic physiological needs. When your basic needs aren’t met, your body lets you know, though maybe not always in a way that makes straightforward sense to us.

The same is true for our emotional needs, which, contrary to Abraham Maslow’s hierarchy of needs, are just as pressing and basic as physiological ones, we just don’t have physical “attention receptors” to signal our needs. This lack is definitely not because we don’t need attention. Emotional and relational needs are not only just as real as physical ones; the two are intertwined: one of the physical needs Maslow lists at the base of the pyramid is safety. “Safe” is hard to feel — and, increasingly harder to be — when you are alone. More and more of us cannot meet our physical needs by ourselves, especially when we get sick or injured, and the only reason we subject ourselves to attempting to provide for all of our own needs alone is because the myth of individualism paired with capitalism’s need for us to compete with one another has threaded itself deep into every aspect of the way we think, form beliefs and run our society.

Maybe one reason we have no physical attention receptors is because we — other humans — are supposed to be those attention receptors for each other. There are obviously a lot of unknowns about the distant past, but one theory might be that we used to live in such close-knit tribes and people were so often in the presence of others that it would be easy to discern when someone in the group needed help or support. Whereas now, you still don’t get help or attention even when you ask, which you have to do because most of our time is spent alone in hastily constructed boxes under screaming fluorescent lights.

If we freely gave each other — let’s just start with our loved ones, since there’s pretty compelling research (google John Gottman) that attention is absolutely necessary for the survival of our intimate relationships — the attention we don’t grow out of needing, maybe people wouldn’t have to develop mechanisms by which they get attention. Sure, there are always going to be exceptions, but on the whole, the fact that “attention-seeking behavior” exists is a systems failure, not individuals playing games. And the fact that we shame people for acting like they need attention and for actually needing attention is self-defeating and maddening, not to mention absurd. Denial does not make anything magically disappear. Isolating people who need attention because they need attention is as cruel as it is culturally accepted.

We’re supposed to pretend like we don’t need something we very much do by virtue of our existence as human beings in order to get it, or hide away if we can’t? And we’re surprised at the pathological lying bulldozing our political systems and the ascension of opinion well above fact? Of course, attention shaming is not the only factor involved in our current epistemological crisis, but it definitely plays a role. If the only way to get a fundamental need met is dishonestly, it’s difficult to see how we could possibly expect anything but a post-truth world.

This might sound dramatic and ridiculous but stay with me here. Attention is about attachment and attachment is about developing well when we’re young and our relationships to each other as we age. It’s very clear from solitary confinement that many of those who endure the torture are unable to hold onto their sense of self or their story and suffer great emotional and mental distress. A similar warping occurs when we are able to silo ourselves off into a world of our making, listening only to voices we agree with, which is solitary confinement in another form. Individualism mandates that we meet all our needs ourselves, and it is shredding our ability to speak, think and act meaningfully. In the absence of our attending to one another, we as individuals — and our relationships — flounder while post-truth and all its frightening consequences flourish.

Don’t take me to be implying by ‘post-truth’ that there is one single thing out there called Truth that we all must adhere to, or even the often-lamented loss of a “shared narrative.” I simply mean by post-truth that truth in any form no longer matters — integrity is supplanted by what is called ‘authenticity’ or ‘honesty’ but is really cruelty and selfish indifference toward others. It may seem like not agreeing on a shared reality is one of the reasons for our truth crisis in politics, that losing this idea of shared facts is one of the reasons that it’s nearly impossible to have civil discussions with each other anymore. But only in a post Enlightenment culture obsessed with “rationality” and “reason” and terrified of human emotion or experiences that stray too far from what’s normal (which really means what’s comfortable for those capitalism keeps in power) would the loss of a shared narrative create so much hand-wringing. There are many ways of knowing, including relational and experiential knowing, that this idea of a shared narrative crowds out. Forcing agreement on one shared story, which will no doubt be created by those who hold the most power, is oppressive and dangerous for people who have experienced the dominant paradigm labels, diagnoses and “treatments.”

So it’s not just that shaming people for wanting attention is basically shaming people for being human, which was no one’s choice, at least not anyone I know. It’s also that reinforcing the idea that attention is a bad thing to want and a bad thing to give is contributing to the disabling of our relationships and thus the social fabric.

This is not to excuse mistreatment, manipulation or abuse. You do not have to give attention to someone just because they demand it — like if you’re a woman walking down the street and a man whistles at you and then calls you an unfriendly bitch if you don’t turn your head in his direction. You do not have to respond to every bid for connection that comes your way, even if it’s genuine. You as an individual do not owe anyone your time or attention. But we have a social system that allows for the public shaming of others who in many cases are admitting to their loneliness the best way they know how given the emotional constraints of a system that would rather tar and feather you for being unhappy about being alone than give you a friend, and that’s not okay. Not being obligated to give anyone attention who legitimately needs it (which is everyone to varying degrees) does not logically have to translate to shaming people for needing attention.

While there may be difficulties with how people seek attention, there is absolutely nothing wrong with needing attention. It’s not just that I want attention shaming to stop, though I do. It’s not that I think we are each personally responsible for providing every person in our lives with their required amount of attention. It’s not that I think making it a safe place to ask for attention is going to fix everyone’s problems. It’s that the kind of attention those of us who’ve had contact with the mental health system (which almost inevitably involves the police and/or the legal system) have received has been extremely unsafe and has inflicted long-lasting damage and I want that to change. What we need is an empathetic — not just safe, but truly compassionate — place to express despair, where ‘safe’ means no possibility of law enforcement involvement, involuntary detainment or forced treatment. We aren’t going to get that until attention shaming is put forever to rest.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. This is my favorite kind of article – easy to read because it’s well written while at the same time opening up lots of room for considering current issues in a different light.

    I personally am seeing it from the perspective of a daughter of a narcissistic mother – she knew how to get attention in dishonest yet socially acceptable ways. I’m not so good at that so I get to be labeled “mentally ill.” And yet, despite the damage inflicted on me by this person, I can also feel a bit of compassion for her (while not excusing the behavior), because perhaps it wasn’t “evil” but a survival mechanism that caused her to act the way she acted.

    When I was heavy on the “meds” that were supposed to help me, there were lots of times that outsiders rejected my attempts for attention. The “meds” and diagnosis made me feel weird and even more insecure than previously. I’m pretty sure other people could see that too and they often rejected me because of it.

    On the flip side, in the previous place I lived, there was a young man with obvious “issues.” He had an unusual manner, and on reflection, I’ve come to think he was probably showing signs of akathisia*. One time, I saw him pacing the coffeehouse we were both at and reading a book at the same time. I tried to treat him kindly even though he sometimes acted in an abrupt manner. I say the flip side, because I saw others closer to his age treating him well and on at least one occasion trying to make him part of their little group. This gives me some hope.

    But, there may be a sort of group survival mechanism involved in why people reject attention seekers who don’t do it in the “right” way, too.

    At any rate, I really appreciate this article. Maybe I’ll add more later – either way, I look forward to seeing other people’s comments.

    *Note to Steve as moderator: Is it possible that the MIA web person can alter their spellcheck to make “akathisia” acceptable and not be red-lined? That is, IF, I’m spelling it correctly. Pretty sure (but not positive) I am. Thanks! (Edit: I see that it is not red-lined as posted, but only when writing/editing the comment, so maybe not a huge deal, but still it’d be nice.)

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  2. I agree but also feel wary.

    I have spent a lot of my life meeting the needs of people who were unable to reciprocate. Their loneliness may have been inevitable because the only way to be truly connected is through equal, reciprocal relationships.

    I understand that our communities ostracise those who are different and behave as though they are not worthy of relationships, and also punish normal human needs. This does mean people are left alone, without the means for getting their relational needs met. As you say, that is a failure of our communities.
    But I feel very wary of ever again being in the self destructive position of feeling guilted into meeting the needs of those who use others and do so by manipulating their empathy but are unwilling or unable to empathise with the feelings and needs of others. This too is a lonely and soul destroying place to be.

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  3. psychiatry feeds on pathologizing the human needs of outliers and misfits, even ‘normals’ who are just at a vulnerable point in life can be preyed upon by the psych guild. the culture as a whole feeds the process, maintains the process, then destroys the damaged souls who end up on the discard heap.

    this may not be the most popular solution, but…I do think it is worth noting that even Szasz writes about psychiatry as a -false religion-, one that infiltrates and destroys -real religions-. Actual, real, meaningful religions can have extraordinary benefits for individuals, families, communities, and society as a whole. I seem to recall Lasch and others writing about this…the fundamental importance of family, faith, meaningful social bonds, “life with limits,” etc. 🙂

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    • Its sad if another religion is the only hope for inclusion and meaningful relationships. It seems to me that faith communities are often as superficial and excluding as the communities the members are drawn from. And then there is the other problem of needing to actually share the tenets of a faith. I know there are many within who don’t, but I don’t think it would help a person with meaningful relationships to be trying to fake it.

      I don’t know what the answer is. Social exclusion and loneliness can make for vicious circles that vulnerable people get trapped by. One of the saddest results is people getting trapped in psychiatry because of their normal unmet needs, and thereby perpetuating that cycle within the original vicious circle.

      Sadly, for most it seems that moving away and establishing a new identity is the best answer. But that is incredibly hard to do from a place of having been badly hurt finding it hard to trust and lacking both confidence and ‘social credentials’. It can easily lead to abusive relationships and worsening confidence and well being.

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      • Its sad if another religion is the only hope for inclusion and meaningful relationships.

        Yeah, that’s a reactionary concept; religion generally exists to hold spirituality in check, or ensure that it is experienced and expressed in controlled ways.

        Meaningful relationships involve loyalty and commitment to others beyond one’s employer, which is absolutely bad for business.

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          • Pointing out the hypocrisy or hidden abuse going on in a church is a great way to get in trouble. I grew up as a preacher’s daughter so I know.

            Not all churches do this. But some are about hiding ugly family secrets–wife beating. Emotional abuse of children. Secret drinking binges when everyone’s supposed to be a teetotaler. Affairs. “Everyone” knows these things go on, but you aren’t allowed to say it out loud. Just smile big and say things are perfect and you feel so blessed.

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  4. Sometimes I think that early in life, depending on how parents respond, a child can come to believe that seeking attention is shameful, and this rule becomes stuck at a basic level. Later, when there may be opportunities to connect, the rule makes it unsuccessful. People around them believe they would rather be left alone, and so, oblige them. All the while another part of the mind is wanting very much to fit in. Believing that we have unitary and freely accessible minds justifies blaming the individual, who they say should just change his mind.

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    • I think this is very well said, and resonates with my own experience. I’d only add that there is a general hostility toward “attention seeking” by children that goes back many generations, and that this is particularly evident in the structure of the average school classroom. Even kids with loving and rational parents are exposed to massive anti-attention-seeking propaganda and punishment from their school in the majority of cases. To intentionally seek attention in an assertive way is very much discouraged in society. It is much preferred if we keep quiet and go along with the program, in my experience.

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  5. I’m not sure how I missed this article, but MIA just pointed it out to me at the end of another recent article.

    I was one of those children who was shamed for seeking attention. I was the youngest child of two working parents and three much older siblings in the home. I was an “only child” by 12. My siblings left home young and never looked back. A very common refrain growing up was “K*** will take any attention she can get, positive or negative.” They never took this as a sign that I actually needed attention.

    I grew up relatively feral, I was alone much of the time, I wandered the neighborhood alone from a young age, missed a lot of school because no one was home to care if I went, and I missed a lot of meals because my siblings were old enough to fend for themselves and my mother sometimes didn’t come home for several days at a time.

    It does seem like this “attention deficit” carried over into an adult – at least in terms of how I think of my own attention needs. Of course, now we have the put down “attention whore” to shame people’s need for intimacy and connection. I have recently started reaching out to try to form closer relationships and I’ve been rewarded for the effort, but there’s still that nagging voice inside that I’m “bothering” people simply for existing and it still feels like I’m making demands on people’s time.

    I think you bring up really good points about how people end up being shamed and ostracized for simply needing human connection. Thanks, Megan.

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    • Jesus, I just had a revelation.

      What if the real problem we call “attention deficit disorder” isn’t that a child can’t “pay attention” but that they need to be “paid attention to”. Why is inability to sit still in school or conform to rigid rules in social institutions considered a deficit within the child rather than a deficit within the family and culture?

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    • It has always bugged me when someone says, “Oh, they JUST need attention!” As if needing attention is some trivial thing, or that the child is being somehow selfish by needing it. Attention is survival for young kids, they will literally DIE without attention. And the need for social connection is vital to all humans. The minimization of kids’ need for attention is a sign of people who really don’t like or understand children at all. Which says a little something about the psychiatric profession.

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  6. “Forcing agreement on one shared story, which will no doubt be created by those who hold the most power, is oppressive and dangerous for people who have experienced the dominant paradigm labels, diagnoses and “treatments”.”

    Psychiatry and psychotherapy exploit people’s need for attachment and attention.

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