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ADHD

ADHD and the Problem of the Double Hermeneutic

The categories we use to describe people change people.

My guess is that, clicking on this link, you are wondering what on earth is the “problem of the double hermeneutic” and how could it relate to Attention Deficit/Hyperactivity Disorder? I apologize in advance for the arcane sounding terminology. But if you ever wondered about the relationship between scientific categories and how people think about themselves, you should be aware of the “problem of the double hermeneutic”.

First, though, an update on ADHD. (This was reported on last week in the New York Times by Alan Schwartz). Keith Conners is a psychologist who was an early advocate for the identification and treatment of ADHD. When he started his early investigations, he was convinced that there were a small subset of children, 1-2% at most, who really had some unique challenges that could be offset by certain stimulant medication. And his research was instrumental in raising awareness about the condition. Given all the attention that ADHD now receives, one might think that he feels triumphant.

Actually, not so much. Instead, he noted the enormous increase in numbers of diagnoses (now upwards of 15% of high school children) with dismay and called it “a national disaster of dangerous proportions.” Is there an emerging epidemic of ADHD? No, an idea he called “preposterous”. Instead the dramatic rise is the result of a “concoction to justify the giving out of medication at unprecedented and unjustifiable levels.” Indeed, the NY Times article is titled, “The Selling of Attention Deficit Disorder” and is centrally concerned with the ways the psychopharmacology industry influences societal attitudes to broaden certain categories that are “treatable” via drugs. In other words, as scientists investigated a phenomenon, the sociology of the situation changed such that it had a major impact on how people actually operate. This is the essence of the problem of the double hermeneutic, which is a problem that everyone who does social/human science research should be aware of.

To understand the problem, let’s start with the word “hermeneutic.” A hermeneutic refers to a method or system of interpretation. In psychology and the social sciences, hermeneutics refers to the ways people develop systems of meaning and justification that allow them to make sense out of the world.

Anthony Giddens is the scholar who identified the problem of the double hermeneutic. According to Giddens, physics, chemistry, biology and other natural (i.e., nonhuman) science disciplines are "single" hermeneutic disciplines in that scientists must develop shared systems of thought about the appropriate way to describe the natural phenomena in question. He noted these scientists can generally be safe in their assumption that the discourse about the objects per se will do little to change the phenomena under investigation. Thus, the observer and observed remain in their rightful places in natural science disciplines (complications from quantum mechanics notwithstanding), and natural scientists generally do not need to concern themselves with the question of what their knowledge justifies because their subjects will not co-opt this knowledge and change their very nature in the process.

However, the situation changes radically when the observed is a concept-using being whose very conceptions of their actions enter into the actions themselves. According to Giddens, “The concepts and theories invented by social scientists circulate in and out of the social world they are coined to analyze”. In other words, the justifications generated by human scientists to explain some human behavioral phenomenon are digested by human actors with genuine causal consequences. Thus human sciences are fundamentally different from the natural sciences because they confront a “double” hermeneutic.

The double hermeneutic then refers to the problem that theories of human behavior (including theories of mental disorders like ADHD) will interact with existing public justification systems, and because of this, knower and known are no longer so neatly separable. This reality has lots of complicating ramifications for how we think about scientific facts, values, philosophy, and what theories we "ought" to promote more generally.

The point that I want to illustrate here is that what has emerged with ADHD is a striking example of the complicated nature of the “double hermeneutic”. The lesson is a cautionary tale about how "purely" scientific constructs and categories can come to morph into culture and be morphed by culture. The bottom line is that applying science to humans is a complicated business indeed.

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