I would add in that unless you ditch the term neurotypical you are implying that there is such a thing. I don't think there is any possibility that an "average" brain exists. We are all neuorminorities with fairly well known variables. If any brain type is close to "neurotypical," it would be the brainset that has proven itself by still existing as the one with the best threat responses (survival capabilities). I don't think anyone would argue against natural selection as favoring those humans who had the best threat responses.
Thus, there are very few humans left that can actually NOT get addicted to anything, even if they try. They also happen to be the brain type with the best working memory operations. They can actually resist the distraction. Research shows that they are also a population that "needs cognition." They also happen to be the worst at threat response.
Some really significant studies have been done to try to figure out what group, if any, might be more easily influenced by their environment when it comes to "self-regulation." And, what group, if any, would be significantly immune to environment. The most significant study revealed a clear population that was called "straight arrow." Several other studies have looked at certain populations of similar dopamine gene profiles. Groups of kids and their family styles were followed for years and data was collected regarding "self-regulation" and family styles and if there was a vulnerability to family self-regulation styles.
I don't have those right in front of me at the moment, but they are easy enough to find by searching for "the 2010 Guo straight arrow study" and the other study "Posner drd4 7/r self-regulation study." I could go into much more detail, but, I suspect that could be very boring for most folks. If you are curious-driven, you might want to look at those studies and any newer ones which, so far, have supported the earlier findings.
The Posner study clearly showed that one population of kids with drd4 7r were heavily influenced by their family styles. If the family was "chaotic" (my word), that is, did not show or teach "self-regulation" the drd4 7r types showed significant impaired self-regulation. If the family style was "self-regulation" the drd4 7/r kid could self-regulate. Thus, that Posner study, plus others since then have shown a "vulnerability to environment" (read, can't easily stay on a planned course).
The kids with the drd4 4/r or 4/7 could self regulate whether the family style was self-regulation or not. (not easily influenced, good at staying on course, etc.)
There has not been enough work to look at does the "teaching and modeling and pressure of a family style of self-regulation (including empathy) stick after the child becomes an adult and subject to many other influences. It depends on how "programmed" the child is in the scenarios of self-regulation. Think LDS upbringing, for instance.
It just so happens that the worldwide prevalence of the drd4 7/r is something like 50% in the Americas (the Western Hemisphere) and around 2% in East and Southeast Asia, and variable throughout Europe with an average of 20% to 45%. Worldwide it is around 21%.
For me, after 20 years of clinical work with folks who fit the criteria for the diagnosis of ADHD and over 30,000 pages of primary literature review, I concluded that the major brain type in the West is the ADHD brain type. It is now becoming clear that the culture fits the criteria for ADHD. It didn't just come out of nowhere. Unless the elephant in the room is cleary noted and dealt with, good luck on anything that doesn't carry huge peer pressure value. Toxic commercialism (monetizing everything, my god) will not be resisted due to the peer pressure it creates.
With an easy to influence population that does not recognize its widely embedded vulnerabilities to being influenced and overwhelmed with data, there is not much of a chance of changing that unless the vulnerability is clearly discussed and appreciated. It is, in my opinion, this scenario presents the West with its most unrecognized and understood public health problem.
Empathy, in my world, cannot really take place automatically unless you possess good working memory. It is one thing to feel something, and another thing to follow-through (empathy). "Out of sight out of mind" is the opposite of auto-empathy. Thus, given the widely embedded poor working memory in the West, there is not much chance of empathic styles to gain a foothold, unless you know what the constitutes the major variable in what controls it – what makes it "automatic" and what makes it "non-automatic."
If you look at Posner's work and others, you could come to the conclusion that given the West's vulnerabilities, the only way to increase "self-regulation," including empathy, is to create a self-regulating society. In the West, good luck on that. As Posner's and others have shown us, our West population might be able to do self-regulation, but if self-regulation is not even an acceptable goal, and is actively pursued, not a chance.
Toxic commerce uses that widespread vulnerability to being influenced, distracted, entertained, and imbibers of all things dopamine enhancing, *against* us.
I wrote a book published in 2013 that discusses much of this vulnerability and also the upside to dopamine processes that create the characteristics of ADHD and the best brain for survival (threat response). Good threat response, poor academics. NonADHD, good academics, poor threat response.
Thank you for your post on empathy. It is not going to be easy to get there, but that doesn't mean we can't figure it out and move in the right direction. Take care, Ron
I learned a lot from this insightful comment Dr. Sterling- thanks for taking the time to write this out and sharing the specific studies- will be doing some further reading.
Good callout on “neurotypical”-agree it’s a poor word choice, not really better than “normal” whatever that means.
It’s interesting to me that the brains with good working memory/self-regulation capabilities have poorer threat response. I could see the self-regulation maybe dampening the response, but I would think the working memory would enhance threat detection.
Hi Dr. Mushtaq! What I wrote about in 2013, and what I am trying to update 12 years later, was exactly to answer that question. What I had noticed in doing lengthy evals with my own questionnaires, and what I learned from the literature, made me stop using the term "deficiency."
Deficiency implies a too simple process. The moving parts to the dopamine system (which is huge, not just CNS) are manufacturing, storing, releasing, transmission, reabsorption, loss due to enzyme functions, whether released in white or grey matter areas, and more.
Optimal dopamine processes for optimal working memory follows an inverted u-shaped curve. For those who start off at baseline optimal dopamine for optimal working memory, any thing that pushes it above optimal produces problems -- longer reaction times, downgraded working memory, forgetful, disorganized, shaky, increased heart rate and blood pressure, nausea (mild to severe).
So, one of the things that was not getting proper attention was how much threat response depends on the correct amount of dopamine utility, not too much tonic and phasic dopamine, but just the right amount. Since threat "stimulates" dopamine functioning (presence and other things) for everyone, that means those with great working memory at baseline get over-amped and less effective. Longer reaction times are not useful in survival, etc.
However, threat essentially "treats" ADHD by moving dopamine system effectiveness (tonic and phasic dopamine) toward optimal rather than quickly to above optimal. What this means is that their reaction times get faster (great for survival), and they get more able to focused, react, plan, stay on task, not feel sick, etc. Non-ADHDers get worse, ADHDers get better.
Of course, threat is generally not always so constant, unless you choose it to be, so it can't really be used as a treatment of ADHD (hope that makes sense). This is one of the reasons I recommend that folks who are on dopamine enhancers might rethink being on meds when they go skydiving. Their "natural" (baseline) dopamine is the best to start with for success in threat situations. Over amping is not helpful.
So, I tend to use the phrase "dopamine needers" and "dopamine non-needers. In my world, I find it interesting an unfortunate that nonADHDers have no proven and useful way to lower dopamine for better functioning in threat situations, but ADHDers can more or less have two brains. One for study (on meds), one for rock-climbing or cage fighting, etc, (off meds).
My 2013 book spends a lot of time discussing what I knew then (which has not been significantly challenged), but I am now trying to update and fact check it against research done since then.
for optimal working memory means that when a threat shows up, dopamine processes quickly enhance tonic dopamine and the phasic dopamine to above-optimal.
Thanks for this in-depth info! Agree on “deficiency”- I think in so many MH conditions there’s an element I’m how attention is upregulated and down regulated.
Forgot to mention that the lit is really clear on reaction times in nonADHDers vs ADHDers. With optimal baseline dopamine, nonADHDers clearly have a larger, quicker startle response. ADHDers, variable from slow to fairly fast, but not like in the optimal dopamine situation. BTW, all of this is being said about people who do no have sensory sensitivities, which adds a whole different variable to the situation of threat response. About 10-15% of ADHDers are also dealing with significant sensory sensitivities, so they don't necessarily have the same capabilities for threat response.
It really has become a skill, a tool that needs to be sharpened, to have attention. Not including that most news, major events, and other information is mostly consumed through numerous social media platforms. It’s a cycle that deemed the great human brain to nothing more than an empty vessel that struggles to keep much in.
Thank you for this. Reading does truly help with attention spans, and with fostering empathy. Reading opens one to a much wider world, and set of world views, and ways of approaching telling a story – Dickens, for example, takes much longer to “get going” than current prose. This is especially true when reading older books, like from 100+ years ago, or from another culture. And we don’t really read any longer like we used to, that is, we more easily skim text while reading online.
That said, I read a lot, and always have, and it feels like verbosity and repetition and empty words have become the malady du jour. Writers are no longer editing their work, and simply – in the worst cases – “vomiting” thoughts onto the page, probably in the main due to posting deadlines and time constraints.
However it’s not just online work, but printed books, also. Authors of contemporary fiction seldom seem to know when to stop, and what to not include in their stories. A related malady is mistaking the verbal expression of a story with a good plot and character development, i.e., exquisitely beautiful prose with nothing of substance underneath it. (Many modern films have much the same problem, IMHO.) With regard to non-fiction, there is too much repetition of ideas and simple verbosity, and also not knowing when to stop or be succinct. As one example, I have read a lot of G.K. Chesterton, and, while liking his work, his writing methodology was to dictate to a secretary with little editing after, and his work reads like it, especially when compared to other notable writers whose work is far “tighter”, focused and concise. And as a design professor, my students often have the same problem – they want to include ALL their design ideas into ONE project, which ruins the whole concept.
In consequence of this, yes, I skim an awful lot of online content, because the writers take far too long to get to the point, and end up circling around it, unless of course the “point” requires a lot of background information. I also find myself seldom finishing more recent books, for the same reasons. Admittedly, some of the problem is my own more truncated attention span these days, along with increased time constraints, though I still read older history, poli-sci, theology and philosophy texts without problem.
I think that’s a really interesting point about how the shift is noticeable in both online articles and novels. I’m curious about that, I wonder if that’s a symptom of or a response to the shifts in the reader. If our critical thinking abilities have declined, perhaps we’re less likely to be able to discern what’s lacking in a writer’s technical abilities? Or perhaps we actually want less substance in the writing?
It's interesting you should reply just now. I've been thinking a fair bit about what I wrote, and who I DO read in long form. I happened to read a longer analytical piece today by Victor Davis Hanson, and had no difficulty whatsoever getting through it. There was no duplicativeness of thought, no verbosity, just well written, concise and well thought-out ideas and support for same.
To your points, as a professor, I was several years ago rudely made aware of how so many students these days do not know how to parse even well-written and organized prose. My students were complaining about the difficulty of very clear, technical text where each paragraph was short, concise, and had a topic sentence and ending summary. As for wanting less substance, again, my problem is quite the opposite, getting through all of the excess verbiage to actually find what the author is trying to say. Beautiful prose without underlying substance is like so much cotton candy. One could add in a lot of contemporary so-called poetry....
What you're describing IS very accurate, however in my own experience the ability to express ideas clearly and succinctly, and to think clearly, has also gone through the floor. In the same vein, I was reading someone else today, and couldn't finish the article due to the extreme repetitiveness and lack of focus of the writer on the topic. The article should have been about 1/3 the length it was. Although I've also come to realize that analytical writing these days must put in so much background, maybe due to readers not being familiar with the topic, that again, I pass over most of it to get to what they're really wanting to say.
Spot on!
I would add in that unless you ditch the term neurotypical you are implying that there is such a thing. I don't think there is any possibility that an "average" brain exists. We are all neuorminorities with fairly well known variables. If any brain type is close to "neurotypical," it would be the brainset that has proven itself by still existing as the one with the best threat responses (survival capabilities). I don't think anyone would argue against natural selection as favoring those humans who had the best threat responses.
Thus, there are very few humans left that can actually NOT get addicted to anything, even if they try. They also happen to be the brain type with the best working memory operations. They can actually resist the distraction. Research shows that they are also a population that "needs cognition." They also happen to be the worst at threat response.
Some really significant studies have been done to try to figure out what group, if any, might be more easily influenced by their environment when it comes to "self-regulation." And, what group, if any, would be significantly immune to environment. The most significant study revealed a clear population that was called "straight arrow." Several other studies have looked at certain populations of similar dopamine gene profiles. Groups of kids and their family styles were followed for years and data was collected regarding "self-regulation" and family styles and if there was a vulnerability to family self-regulation styles.
I don't have those right in front of me at the moment, but they are easy enough to find by searching for "the 2010 Guo straight arrow study" and the other study "Posner drd4 7/r self-regulation study." I could go into much more detail, but, I suspect that could be very boring for most folks. If you are curious-driven, you might want to look at those studies and any newer ones which, so far, have supported the earlier findings.
The Posner study clearly showed that one population of kids with drd4 7r were heavily influenced by their family styles. If the family was "chaotic" (my word), that is, did not show or teach "self-regulation" the drd4 7r types showed significant impaired self-regulation. If the family style was "self-regulation" the drd4 7/r kid could self-regulate. Thus, that Posner study, plus others since then have shown a "vulnerability to environment" (read, can't easily stay on a planned course).
The kids with the drd4 4/r or 4/7 could self regulate whether the family style was self-regulation or not. (not easily influenced, good at staying on course, etc.)
There has not been enough work to look at does the "teaching and modeling and pressure of a family style of self-regulation (including empathy) stick after the child becomes an adult and subject to many other influences. It depends on how "programmed" the child is in the scenarios of self-regulation. Think LDS upbringing, for instance.
It just so happens that the worldwide prevalence of the drd4 7/r is something like 50% in the Americas (the Western Hemisphere) and around 2% in East and Southeast Asia, and variable throughout Europe with an average of 20% to 45%. Worldwide it is around 21%.
For me, after 20 years of clinical work with folks who fit the criteria for the diagnosis of ADHD and over 30,000 pages of primary literature review, I concluded that the major brain type in the West is the ADHD brain type. It is now becoming clear that the culture fits the criteria for ADHD. It didn't just come out of nowhere. Unless the elephant in the room is cleary noted and dealt with, good luck on anything that doesn't carry huge peer pressure value. Toxic commercialism (monetizing everything, my god) will not be resisted due to the peer pressure it creates.
With an easy to influence population that does not recognize its widely embedded vulnerabilities to being influenced and overwhelmed with data, there is not much of a chance of changing that unless the vulnerability is clearly discussed and appreciated. It is, in my opinion, this scenario presents the West with its most unrecognized and understood public health problem.
Empathy, in my world, cannot really take place automatically unless you possess good working memory. It is one thing to feel something, and another thing to follow-through (empathy). "Out of sight out of mind" is the opposite of auto-empathy. Thus, given the widely embedded poor working memory in the West, there is not much chance of empathic styles to gain a foothold, unless you know what the constitutes the major variable in what controls it – what makes it "automatic" and what makes it "non-automatic."
If you look at Posner's work and others, you could come to the conclusion that given the West's vulnerabilities, the only way to increase "self-regulation," including empathy, is to create a self-regulating society. In the West, good luck on that. As Posner's and others have shown us, our West population might be able to do self-regulation, but if self-regulation is not even an acceptable goal, and is actively pursued, not a chance.
Toxic commerce uses that widespread vulnerability to being influenced, distracted, entertained, and imbibers of all things dopamine enhancing, *against* us.
I wrote a book published in 2013 that discusses much of this vulnerability and also the upside to dopamine processes that create the characteristics of ADHD and the best brain for survival (threat response). Good threat response, poor academics. NonADHD, good academics, poor threat response.
Thank you for your post on empathy. It is not going to be easy to get there, but that doesn't mean we can't figure it out and move in the right direction. Take care, Ron
I learned a lot from this insightful comment Dr. Sterling- thanks for taking the time to write this out and sharing the specific studies- will be doing some further reading.
Good callout on “neurotypical”-agree it’s a poor word choice, not really better than “normal” whatever that means.
It’s interesting to me that the brains with good working memory/self-regulation capabilities have poorer threat response. I could see the self-regulation maybe dampening the response, but I would think the working memory would enhance threat detection.
Hi Dr. Mushtaq! What I wrote about in 2013, and what I am trying to update 12 years later, was exactly to answer that question. What I had noticed in doing lengthy evals with my own questionnaires, and what I learned from the literature, made me stop using the term "deficiency."
Deficiency implies a too simple process. The moving parts to the dopamine system (which is huge, not just CNS) are manufacturing, storing, releasing, transmission, reabsorption, loss due to enzyme functions, whether released in white or grey matter areas, and more.
Optimal dopamine processes for optimal working memory follows an inverted u-shaped curve. For those who start off at baseline optimal dopamine for optimal working memory, any thing that pushes it above optimal produces problems -- longer reaction times, downgraded working memory, forgetful, disorganized, shaky, increased heart rate and blood pressure, nausea (mild to severe).
So, one of the things that was not getting proper attention was how much threat response depends on the correct amount of dopamine utility, not too much tonic and phasic dopamine, but just the right amount. Since threat "stimulates" dopamine functioning (presence and other things) for everyone, that means those with great working memory at baseline get over-amped and less effective. Longer reaction times are not useful in survival, etc.
However, threat essentially "treats" ADHD by moving dopamine system effectiveness (tonic and phasic dopamine) toward optimal rather than quickly to above optimal. What this means is that their reaction times get faster (great for survival), and they get more able to focused, react, plan, stay on task, not feel sick, etc. Non-ADHDers get worse, ADHDers get better.
Of course, threat is generally not always so constant, unless you choose it to be, so it can't really be used as a treatment of ADHD (hope that makes sense). This is one of the reasons I recommend that folks who are on dopamine enhancers might rethink being on meds when they go skydiving. Their "natural" (baseline) dopamine is the best to start with for success in threat situations. Over amping is not helpful.
So, I tend to use the phrase "dopamine needers" and "dopamine non-needers. In my world, I find it interesting an unfortunate that nonADHDers have no proven and useful way to lower dopamine for better functioning in threat situations, but ADHDers can more or less have two brains. One for study (on meds), one for rock-climbing or cage fighting, etc, (off meds).
My 2013 book spends a lot of time discussing what I knew then (which has not been significantly challenged), but I am now trying to update and fact check it against research done since then.
for optimal working memory means that when a threat shows up, dopamine processes quickly enhance tonic dopamine and the phasic dopamine to above-optimal.
Thanks for this in-depth info! Agree on “deficiency”- I think in so many MH conditions there’s an element I’m how attention is upregulated and down regulated.
Forgot to mention that the lit is really clear on reaction times in nonADHDers vs ADHDers. With optimal baseline dopamine, nonADHDers clearly have a larger, quicker startle response. ADHDers, variable from slow to fairly fast, but not like in the optimal dopamine situation. BTW, all of this is being said about people who do no have sensory sensitivities, which adds a whole different variable to the situation of threat response. About 10-15% of ADHDers are also dealing with significant sensory sensitivities, so they don't necessarily have the same capabilities for threat response.
It really has become a skill, a tool that needs to be sharpened, to have attention. Not including that most news, major events, and other information is mostly consumed through numerous social media platforms. It’s a cycle that deemed the great human brain to nothing more than an empty vessel that struggles to keep much in.
There’s definitely systems at play hijacking our abilities and it raises the question of —who does it benefit for us to be so distracted?
“We’re not meaningfully affected.”
So much to think about, here.
Reading this, I reflect on how my clients seem starved for this kind of attention and empathy in their relationships.
Thank you for this. Reading does truly help with attention spans, and with fostering empathy. Reading opens one to a much wider world, and set of world views, and ways of approaching telling a story – Dickens, for example, takes much longer to “get going” than current prose. This is especially true when reading older books, like from 100+ years ago, or from another culture. And we don’t really read any longer like we used to, that is, we more easily skim text while reading online.
That said, I read a lot, and always have, and it feels like verbosity and repetition and empty words have become the malady du jour. Writers are no longer editing their work, and simply – in the worst cases – “vomiting” thoughts onto the page, probably in the main due to posting deadlines and time constraints.
However it’s not just online work, but printed books, also. Authors of contemporary fiction seldom seem to know when to stop, and what to not include in their stories. A related malady is mistaking the verbal expression of a story with a good plot and character development, i.e., exquisitely beautiful prose with nothing of substance underneath it. (Many modern films have much the same problem, IMHO.) With regard to non-fiction, there is too much repetition of ideas and simple verbosity, and also not knowing when to stop or be succinct. As one example, I have read a lot of G.K. Chesterton, and, while liking his work, his writing methodology was to dictate to a secretary with little editing after, and his work reads like it, especially when compared to other notable writers whose work is far “tighter”, focused and concise. And as a design professor, my students often have the same problem – they want to include ALL their design ideas into ONE project, which ruins the whole concept.
In consequence of this, yes, I skim an awful lot of online content, because the writers take far too long to get to the point, and end up circling around it, unless of course the “point” requires a lot of background information. I also find myself seldom finishing more recent books, for the same reasons. Admittedly, some of the problem is my own more truncated attention span these days, along with increased time constraints, though I still read older history, poli-sci, theology and philosophy texts without problem.
I think that’s a really interesting point about how the shift is noticeable in both online articles and novels. I’m curious about that, I wonder if that’s a symptom of or a response to the shifts in the reader. If our critical thinking abilities have declined, perhaps we’re less likely to be able to discern what’s lacking in a writer’s technical abilities? Or perhaps we actually want less substance in the writing?
It's interesting you should reply just now. I've been thinking a fair bit about what I wrote, and who I DO read in long form. I happened to read a longer analytical piece today by Victor Davis Hanson, and had no difficulty whatsoever getting through it. There was no duplicativeness of thought, no verbosity, just well written, concise and well thought-out ideas and support for same.
To your points, as a professor, I was several years ago rudely made aware of how so many students these days do not know how to parse even well-written and organized prose. My students were complaining about the difficulty of very clear, technical text where each paragraph was short, concise, and had a topic sentence and ending summary. As for wanting less substance, again, my problem is quite the opposite, getting through all of the excess verbiage to actually find what the author is trying to say. Beautiful prose without underlying substance is like so much cotton candy. One could add in a lot of contemporary so-called poetry....
What you're describing IS very accurate, however in my own experience the ability to express ideas clearly and succinctly, and to think clearly, has also gone through the floor. In the same vein, I was reading someone else today, and couldn't finish the article due to the extreme repetitiveness and lack of focus of the writer on the topic. The article should have been about 1/3 the length it was. Although I've also come to realize that analytical writing these days must put in so much background, maybe due to readers not being familiar with the topic, that again, I pass over most of it to get to what they're really wanting to say.
I know I have none 😂