Attention, A Love Story

Or: Gradgrind in an Extended-Release Capsule

What is love? If you’re my age, a hard question to ask without bobbing your head. A harder question to answer. One attempt, from a medical journal: love is an “emergent property” of “neuropeptides and neurotransmitters.” To fall in love, release dopamine and norepinephrine into the appropriate neural pathways, as determined by functional MRI imaging. Lost that loving feeling? Don’t blame her cheating heart, or his thoughtless ways – simply tweak those transmitters. Goodbye couples counseling, hello Big Pharma billions.  

Reducing love to its neurochemical correlates may rub you the wrong way, and it’s certainly not a winning strategy on Valentine’s Day. Looking at romance strictly as a neuropeptide affair is a bit like dismissing Michelangelo’s David as just a big rock. Should we search for a more fulfilling definition? I like this one, from French philosopher Louis Lavelle: “Love is a pure attention to the existence of the other.”

Love as a form of attention? The reductionist medical journals would be unlikely to object: the key players in attention, after all, are, you guessed it, dopamine and norepinephrine. Did you not know that? Yes, the most common ADHD stimulant medications work by increasing the levels of those very neurotransmitters in your child’s brain. Wait a sec, you may be saying, the Ritalin my son’s doctor prescribes as a homework aid simultaneously manipulates the neural mechanisms involved in his love life? Isn’t that kind of a big deal? Why didn’t my doctor tell us that? Yes to the first two questions, and I wish I knew to the third.

To illustrate the mad-scientist-level irresponsibility of altering dopamine and norepinephrine levels in your child’s brain for a better GPA, let’s imagine going to the doctor and asking her to harness those neurotransmitters for a different goal: helping your teenager’s love life. Your fourteen-year-old is not really into the dating thing yet, cares more about his sports and his schoolwork. Meanwhile, there’s this lovely girl three houses down, you know her parents, they’re good people. Doc, you implore, you need to prescribe a good love potion for my boy. I’ve found just the girl for him, they’d be great together if only he’d get his nose out of his books long enough to notice her, please, his future happiness is at stake, prescribe something to get his dopamine flowing. Yes, of course I have insurance.

It seems crazy to you now, but trust me, if Big Pharma could make a profit off of Love Potion Number Nine, your local pediatrician would already have a lonely hearts questionnaire ready to go for your preteen at every physical. Score 3/5 points on any of the following to qualify for Romantic Deficiency Disorder:

• does not seem distracted when addressed by cute boys/girls

• acts as if driven by a platonic motor

• reads quietly in his chair every Friday night

• has difficulty engaging in hand-holding activities

• etc, etc.

Hopefully, sensible parents would revolt at such pharma-enabled romantic engineering. Attention engineering is no different. If your conscience shrinks from the former, it must denounce the latter.

Now, hold on a sec, you might object: love is important. It shapes your soul, upends your whole life – it really matters. You don’t throw pharmaceuticals at it to see what happens, that’s playing with fire. You could ruin somebody’s life with that sort of meddling. Attention, on the other hand, is no big deal, it’s just a skill you use to make your teachers happy, like good handwriting. If you’re getting in trouble because Mrs. Jones in fourth period can’t tell your f from your s, and there’s a pill to improve penmanship, what’s the big deal? Take the pill, make teacher happy, improve your grades, everyone wins. That certainly seems to be the attitude taken towards attention by the pharma companies and my fellow pediatricians.

Two responses come to mind. The first is straightforward: I agree, the importance of your romantic endeavors dwarfs your preteen GPA. The choice of whom to marry may be the single most important choice of your life. The choice between answers B and C on your algebra test in sixth grade is unlikely to rate in the top ten. Look at your husband. Look at your wife. Contemplate your life together, your children, the good times and the bad. Would you trade it all to have made your third period chemistry teacher (what was his name again?) feel a bit more heard during class several decades ago? The question is almost too absurd to ask. Whom you marry is worlds more important than what grades you get in middle school. Why, then, do you think it immoral to drug your children for the former but not the latter? If a report card isn’t important, why monkey with your child’s neuropeptide composition on its behalf? 

The second response gets to the heart of the issue. Some might argue, per above, that it’s not that love is more important than attention, it’s that love is of a different sort. Love is sacred ground; attention is a cognitive skill. We can fiddle with attention precisely because it is so, well, inhuman; it’s not truly a part of our soul, merely an adjustable setting on our brain. Is such a view defensible? Is attention a cognitive skill to be upgraded when necessary, like the storage on your cloud account?

The word ‘no’ is not strong enough to convey the wrongness of the answer. Let’s add some letters to it. Is such a view of attention defensible? Noooooooooooooooo. So strongly ‘no’ that language fails to convey the essential ‘no’-ness of it. So thoroughly, harshly, ineffably ‘no’ that for the vast majority of the pediatric medical establishment to hold this view is inexplicable. Doctors are treading on sacred ground with irreverence, and as if that’s not bad enough, they don’t even know it. To borrow an apt term from the neurological literature: when it comes to attention, the educational-pharmaceutical industry exhibits profound anosognosia – that is to say, a lack of awareness of their own disability. Not content to stop at mere ignorance, they are so ignorant they’re not even aware they’re ignorant at all!  

The Lavelle quotation above comes via Dr. Iain McGilchrist’s 2021 magnum opus, The Matter With Things: Our Brains, Our Delusions, and the Unmaking of the World. The polymath McGilchrist is, among other things, an Oxford professor, a neuroscience researcher, a psychiatrist, a philosopher, and a literary scholar. The Matter With Things begins with an overview of how our brains perceive and interact with reality, based on the most up to date neuroscientific research. Interestingly, for a book of genius that will delve into the meaning of truth, reason, and reality itself, McGilchrist chooses to set the stage by honing in on one supremely important concept before any other: you guessed it, attention. Even more oddly, for all his meticulous research and erudition, McGilchrist doesn’t mention ADHD questionnaire rating forms, not a single time. Apparently, attention is a more complex neuropsychological and metaphysical issue than one would gather from the current established medical practice of drugging a child if a checklist finds she “fidgets with hands or feet or squirms in seat.” Indeed, as Lavelle suggests, attention may be as sacred, as foundational, an idea as true love itself.

A key insight from McGilchrist’s synthesis of modern neuroscience: there are different kinds of attention. This is not some faddish educational theory like different “learning styles,” but a scientific fact hard-wired into the structure of our brains. That structure is asymmetrical, divided between the two brain hemispheres, the right and the left. The two hemispheres experience two radically different kinds of attention: “the bi-hemispheric structure of the brain makes possible attending to the world simultaneously in two otherwise incompatible ways” [this, like all the quotations that follow, is taken from McGilchrist’s book]. In both humans and other animals studied to date, “there is a highly significant separation of attention.” Simply put, the left hemisphere is used for “narrow-beam, sharply focused attention to the world, for the purpose of manipulation,” while the right hemisphere pays “open, sustained, vigilant attention to the world, in order to understand and relate to the bigger picture.” Imagine a small bird, flying over a rocky beach – it must pay laser-like attention to the pebbles below if it hopes to find any lunch, while simultaneously attending to the skies above if it wishes to avoid becoming lunch itself. In people today, including in your child’s middle school classroom, the left hemisphere continues to sweat the small stuff, while the right hemisphere, the one with open, vigilant attention to the world, is the hemisphere of friendship and love, “the hemisphere with which creatures approach, appraise, and ultimately bond with their mates.”

There is no more ancient, more profound division in our brains than that between the right and left hemispheres and their vastly different manners of attending to the world. Yet, in ADHD diagnosis and treatment, this fundamental duality of attention is completely ignored – and the doctors don’t even know they’re ignoring it! An apt line from the eminently quotable McGilchrist: “Not ignorance, but ignorance of ignorance, is the death of knowledge.” Ignorance of ignorance, it seems, is not only the death of knowledge, but also the birth of pharmaceutical profits.

Picture a classroom. It is America decades ago, before stimulants took hold of the curriculum. Third period English, sophomore year. The teacher is diagramming a sentence for the class. In the back row, a young man glances away from the chalkboard. His eyes alight for a moment on the bounce of a ponytail, then notice the smile of the girl it adorns. So begins the courtship. Decades later, they dance at their granddaughter’s wedding. Only because, all those years ago, the boy’s broad, wide-open right hemispheric attention momentarily got the better of his narrow-beam, highly-focused left hemispheric attention. Tread lightly, doctors, you are manipulating forces you cannot possibly comprehend.

The science is settled: attention “is not just another ‘cognitive function,’” it is not simply a dial you fine tune on your brain. Far from a cognitive skill to be evaluated by teacher questionnaire, it is “the disposition adopted by one’s consciousness towards the world.” In other words, “the world we experience […] is affected by the kind of attention we pay to it.” The difference between dancing at that granddaughter’s wedding and remembering what Mr. Smith said about dangling participles is a matter of attention, and it may be the most important matter in the world. As McGilchrist eloquently argues, attention is “a moral act: it has consequences.” That is worth repeating, in case any nearby ponytails interrupted your focus: attention is a moral act. And if attention is a moral act, so is compelling attention, and so most decidedly is pharmaceutically reengineering attention.

These pharmaceutical companies, these physicians, these teachers think they’ve got attention all figured out. They don’t know the half of it - literally. Blithely ignorant of philosophy, literature, and even basic anatomy, they recklessly experiment. As McGilchrist explains,

by paying a certain kind of attention, you can humanize or dehumanize, cherish or strip of all value. By a kind of alienating, fragmenting and focal attention, you can reduce humanity – or art, sex, humour, or religion – to nothing. You can so alienate yourself from a poem that you stop seeing the poem at all, and instead come to see in its place just theories, messages and formal tropes; stop hearing the music and hear only tonalities and harmonic shifts; stop seeing the person and see only mechanisms – all because of the plane of attention.

This fragmenting, alienating kind of attention, I believe, is precisely what Dickens was getting at in his portrait of Gradgrind’s classroom, where the children are drilled in every conceivable fact about equine physiology but wouldn’t know a horse if it licked them on the nose. Stimulants may augment focal attention, which can prove very helpful on the upcoming exam – but at what cost? Students are not routinely graded on the right hemisphere kind of attention, the kind that helps you understand that a horse is more than just a mammalian quadruped, that the sentence on the board is pretty funny if you look past the teacher’s grammatical markings, and that your future spouse could be sitting in the next row; since such attention, untested as it is, does not come up for discussion at parent-teacher conferences, parents may understandably disregard it. Do not be such a parent. Do not let yourself get hoodwinked by the ignorant know-it-alls of the pharmaceutical-educational complex; do not let the world your child experiences be limited to what she can most easily be tested on.

Attention is a moral act. When attention is misleadingly framed as a cognitive function, some generic skill, I understand how parents can be pressured into agreeing to medically manipulate their child’s focus. However, once attention is properly understood as the fundamental way in which one’s consciousness is disposed to the whole world, the use of drugs to experiment on a child’s attention is revealed as sacrilege.

Few parents would relish watching their child being taught by a Gradgrind, drilled to the point of dehumanization until, machine like, she could recite the necessary facts at will. Fortunately, thanks to pediatricians across the country, Gradgrind no longer has to pace the front of the class – he is now, in capsule form, being steadily released into the children’s bloodstreams. Yes, your child is now being dehumanized, alienated, fragmented from the true nature of reality, not by some Dickensian villain, but by her morning medicine.   

The left hemisphere is the hemisphere of the standardized test. The right hemisphere is the hemisphere of the moral imagination. Elevating left over right chooses the formal tropes of a poem over its beauty, the plot details of a novel over its impact, the aspect ratio of a film over its characters’ heroism. I suppose I could see a good argument for drugging our children to increase the role one of these hemispheres plays – but it wouldn’t be the left one!  

Let me make a final appeal to the kind of love that transcends fMRI detection. Parents, I get it. The world – teachers, doctors, counselors – is relentlessly pressuring you to focus on your child’s academic performance. However, now that you have had a crash course in neuropsychology, allow me to suggest that this may be due to an unhealthy ‘left hemisphere’ bias, one that manifests in a dehumanizing focus on your child’s grades, instead of on what truly matters to your child’s life as a whole. That pesky left hemisphere is prodding you to hyperfocus on pop quiz performance, and to neglect friendship, romance, moral development, and meaning. It doesn’t have to be that way. Let that right hemisphere have its say. Think not on your child’s grades, think of her life. Think of her loves. Think of your future grandchildren. Don’t sacrifice the sacred joy of dancing at their weddings, not for all the GPAs in the world.  

What is love? The Bible, a more widely accepted authority than even the AAP, teaches us that God is love. Love is God, and love comes from God, the Apostle John explains. Heady stuff, worlds away from the ground covered by your pediatrician in a fifteen-minute visit sandwiched between an ear exam and a throat swab. The next time you leave that doctor’s office, Ritalin prescription in hand, ask yourself: do I want this pill – or the improved report card it represents – to become my child’s god? Do I want her to worship at the altar of School? Because dosing her with mass-produced neurochemicals designed to make her love her homework may leave her incapable of loving anything – or anyone – that matters.

One final question. Take a look around: is the fever of the world being broken thanks to the medical community’s ADHD prescriptions – or is it spiking? A man focused on his task, hurrying to make his deadline, would be unlikely to notice a few small flames on the periphery, let alone turn aside to hear what a burning bush might say. Yet in that moment – a moment, yes, of inattention from his assigned task, but also of far deeper attention to the wonders of life – Moses helped save his people from a fate worse than even a B-minus in algebra. In a world distracted from distraction by distraction, stimulants may be the worst possible solution. Don’t let a pharmaceutically-enhanced focus on the trivial sidetrack you from the salvific. It is in our daydreams, our friendships, our star-gazing, and our birch-swinging – not in our pristine report cards – that we will one day find the anchor of our purest attention, our purest thoughts, and our purest love.

Thank you for reading, please share if you like, and have a great week!