Stoic advice: I have ADD, can I still practice Stoicism?

[Feel free to submit a question for this column, but please consider that it has become very popular and there now is a backlog, it may take me some time to get to yours.]

E. writes: “I’ve had a few close friends who are counselors tell me recently that I exhibit all the signs of adult ADD (I lack the hyperactivity). I’m not sure if it’s true as I haven’t been officially diagnosed yet, but after doing some reading I do seem to exhibit a lot of the traits. Difficulty focusing and working on something unless it’s of great interest, procrastination, forgetfulness, easily overwhelmed emotionally, addiction problems, etc. These often are compounded by frustration with myself and the resultant depression. In my attempts at Stoic practice I had to put it aside, as I was becoming so angry and distraught with myself at my abject failure to practice Stoicism successfully. I couldn’t seem to develop equanimity or moderation. Then I became even worse off as I engaged in self loathing at my failures. It wasn’t until after that experience that I found out about the possibility of ADD being present.”

“How does one practice Stoicism with ADHD? What are the challenges and benefits? There are some obvious and direct traits of ADHD that make it rather difficult to be successful in a Stoic practice. I know there is debate on ADHD, is it an actual brain disorder or just a label affixed to natural behavior at one end of a spectrum? I think the experts would say the former, but I don’t know. I suppose the biggest question for me is how to be kind enough to one’s self that the practice of Stoicism can remain a goal even in the face of slow progress due to ADHD (or even no progress or regression)?”

This question goes to the heart of a general criticism of Stoicism, which I think misses the mark, but that is important to address nonetheless. Before I get there, however, let me put in some remarks concerning your side comment about whether ADD/ADHD is a real thing or not. There actually is significant disagreement within the mental health community, not just about this particular syndrome, but concerning the whole DSM-based approach. Recently, for instance, the National Institutes of Health has decided not to fund research on conditions that are described only symptomatically in the DSM, unless the researchers can show a biological underpinning for the condition, and there is a lot of disagreement about what such underpinnings actually are in the case of ADD/ADHD. This doesn’t mean the condition doesn’t exist or that it does not affect people’s lives, but rather that there is a lot of room for discussion about what it is, what causes it, how to best go about addressing it, and who actually suffers from it. (Here is a conversation I had with Jerome Wakefield, a psychiatrist, about the reliability of the DSM.)

Regardless, you do describe behaviors that will definitely make it difficult to practice Stoicism, so we need to address the issue head on. Indeed, as I said, one of the criticisms of Stoicism is that it assumes a more or less “normal” (meaning, statistically not too far off from the mean) mental condition in order to be practiced. Doesn’t that mean that the Aristotelians, say, were right after all, when they said that virtue isn’t sufficient for the eudaimonic life? If one isn’t in a position to pursue virtue, don’t we need other things as well, which the Stoics classed under the “preferred indifferents?”

I think this is a profound, if perfectly understandable, misconception of the distinction between Aristotelianism and Stoicism, so let me address this point first, then go back to the specific issue of mental disorders and what Stoicism can do about them.

Aristotle said that virtue is necessary but not sufficient for a good life. He was specific about what else is needed: education, wealth, health, and even some good looks. The Stoics, by contrast, equally explicitly said that all those things are preferred, but they are indifferent to virtue, because one can be uneducated, poor, sick, and ugly and yet be virtuous, indeed more virtuous than some people who benefit from the advantages mentioned by Aristotle. One way to look at this is that Aristotelianism is inherently elitist, as only a few people can really become eudaimon, while Stoicism does not discriminate across social classes and other accidents of the human condition.

That said, not only Aristotelianism and Stoicism, but any philosophical practice assumes a sufficiently sound mind in order to be pursued. This shouldn’t be either shocking or somehow considered a victory for the Aristotelians. Think of it in an extreme fashion: a severely mentally handicapped individual, say because of a genetic mutation or an early developmental abnormality, is sufficiently impaired that he is not going to be able to live a normal life at all, which in turn means that practicing philosophy is simply not an option. But nobody would expect him to practice anything, and it would be too much to ask of any philosophy that it somehow suited people completely irrespective of certain minimal basic requirements of mental functionality. (Physical functionality is a different issue: I do believe that even severe physical handicap is no obstacle for Stoic practice, see here, for instance.)

My colleague at City College, Lou Marinoff, wrote a book a few years ago entitled Plato, not Prozac!, in which he presented the case for philosophical counseling. Despite the provocative title (being provocative is one of Lou’s defining characteristics), the introduction immediately makes clear that if someone’s mental conditions are such that he needs either psychotherapy or psychiatric intervention (e.g., Prozac), by all means he should get it. But, adds, Lou, what therapy or medicine is going to do — at best — is to bring your mind back into a zone of functionality from where you can again focus on your life’s issues. The therapy, or the pill, aren’t going to give you answers to the existential questions you face, because they are not designed to do so. That’s where philosophy kicks in. And that’s why the roles of therapy and philosophy are complementary, not antagonistic.

We are now in a position to go back to your specific problem with ADD. There are two pieces of advice I can give you: the first one is along the lines I just sketched. If the problem is sufficiently severe, do go to a professional, get diagnosed, and get medical help. (Again, whether and the extent to which it will work depends on a number of factors, don’t expect miracles.) Simultaneously, resume your Stoic practice, which should be getting better and better as your mental condition improves. Indeed, there is a good chance that the two may work in a positive feedback, with Stoic practice reinforcing the effect of therapy and therapy making it easier for you to practice.

The second bit of advice is, as you put it, to be kind to yourself. Here my favorite source is Seneca, arguably the more compassionate of the Roman Stoics (as distinct from Epictetus’ delightful irony, which however is deployed in the service of a fairly stern, Cynic-like, approach). Consider, for instance, this passage:

“By no wisdom can natural weaknesses of the body be removed. That which is implanted and inborn can be toned down by training, but not overcome” (Letters to Lucilius, XI.1), where he admits that philosophy helps, but is no miracle cure, nor should we expect that much from it.

He continues: “Wisdom can never remove this habit; for if she could rub out all our faults, she would be mistress of the universe … we cannot forbid these feelings any more than we can summon them” (XI.6).

Or consider this excellent advice by Marcus, especially the fourth point:

“There are four principal aberrations of the superior faculty against which you should be constantly on your guard, and when you have detected them, you should wipe them out and say on each occasion thus: this thought is not necessary; this tends to destroy social union; this which you are going to say comes not from the real thoughts — for you should consider it among the most absurd of things for a man not to speak from his real thoughts. But the fourth is when you shall reproach yourself for anything, for this is an evidence of the diviner part within you being overpowered and yielding to the less honorable and to the perishable part, the body, and to its gross pleasures.” (Meditations XI.19)

And finally, even Epictetus agrees on the basic idea that self blame is un-Stoic: “An ignorant person is inclined to blame others for his own misfortune. To blame oneself is proof of progress. But the wise man never has to blame another or himself.” (Enchiridion 5)

So, do seek medical advice — with reasonable expectations — and do practice Stoicism. But especially, forgive yourself for your failings, the important thing is to strive to be better, success is never assured.