Miskinetic Neuropoliticology: The Politics of Contructing and Discipling the Organism of the Brain — Shannon E. Lowe

And on the soft fibres of the brain is founded the unshakeable base of the soundest of Empires.

(Sevan in Foucault, 1995: 105)

There is a normal type of character, for example, in which impulses seem to discharge so promptly into movements that inhibitions get no time to rise. These are the ‘dare-devil’ and ‘mercurial’ temperaments, overflowing with animation, and fizzling with talk.

William James (1890, p.800) Principles of Psychology.(Holowenko, 1999: 1)


This paper emerges out of research on the contemporary neurological disorder, Attention Deficit Disorder with or without Hyperactivity (AD/HD)1. However, it is also an attempt to take seriously Gilles Deleuze’s suggestion that

it definitely makes sense to look at the various ways individuals and groups constitute themselves as subjects through processes of subjectification: what counts in such processes is the extent to which, as they take shape, they elude both established forms of knowledge and the dominant forms of power. … One might equally well speak of new kinds of events, rather than processes of subjectification: events that can’t be explained by the situations that give rise to them, or into which they lead. — Or we can simply talk about the brain: the brain’s precisely this boundary of a continuous two-way movement between an Inside and an Outside, this membrane between them. — I think subjectification, events, and brains are more or less the same thing.

(Deleuze, 1995, 176, emphasis added)

This study of biopolitical subjectivity2 considers the medical and popular construction of AD/HD to be an event in two ways: an event of brain neurology and an on-line event. The study considers recent neurological findings about the lack of a template for the ‘self’ in the AD/HD brain, and looks at ways in which many AD/HDers have taken upon themselves their knowledge-making, diagnosis and treatment via strong on-line community groups. This reading of the disorder that has swept North America and Britain enquires into the status of bodies/brains in control societies by sketching the limits of Foucault’s notion of discipline, and discussing the sustainability of his notions of power relations and ‘the body’. It questions the purchase that the Foucauldian body-of-depth, as that which relations of power operate on and through, has in constructions of bio-medical subjectivity in control societies.

I do not wish to solely reiterate the argument that contemporary socio-economic and political trends resemble Deleuze’s work on control societies more than Foucault’s work on disciplinary societies. The paper adopts a skeptical position towards conceptualisations of control societies in which the Foucauldian body, in so far as it is the material of power-knowledge-pleasure-resistance relations, is assumed to appear on the terrain of control.3 By assuming, and hence transplanting, the disciplinary body on to the terrain of control, theorisations of the biopolitical render themselves unable to read post-body control and deviance in (im)material settings. The way in which control is eluded irrespective of a ‘body-of-depth’ is discussed by following a neuro-trace in the discourse of AD/HD self-control. If the biopolitical is the contemporary terrain of the constituion of politcal subjectivities (as is argued by Agamben, Negri and Hardt, and Virilio), then post-body deviance is not marginal. Instead, it is a ‘central’, shaky foundation that the event of AD/HD is built upon and grows on. This neuro-trace indicates that the routinized micro-surveillance of disciplinary societies should not be seen as occluding the spectacle any more. Both spectacle and surveillance are integral in this architecture of medical subjectivity precisely because the body that helped distinguish between the two has also transformed in its relation to capital and control. The state of disease or disorder is read as a spectacular and continuous management which renders the body-of-depth a by-product to movements of control which no longer need a Foucauldian ‘body’ to rest in or take hold of. The ‘body-of-depth’ is a by-product to the sprawling architecture of ‘self-regulation’ which maintains the institutionalisation of the disorder itself.

A Brief Etiology of AD/HD

AD/HD is ‘one of the most prevalent psychiatric disorders in the U.S.’ (Barkley, 1997: 3)4 and a burgeoning disorder in the UK. In 1895 the German physician Heinrich Hoffman wrote a story about one ‘Fidgety Phil’ who had difficulty sitting still and remaining focused on tasks. The first medical reference to what is now called AD/HD is however generally attributed to the English physician George Still (1902). Through attention to ‘Fidgety Phil’ type children, Still concluded that the ‘immediate gratification of the self [was] the “key note” quality’ of such ‘lawless children’ (Barkley, 1997: 4). The children that he observed also displayed signs of heightened emotionality or passion, insensitivity to punishment and problems with sustained attention. Still’s argument that the children suffered from a ‘defect in moral control’ (Barkley, 1997: 4) was reinforced by the fact that ‘to Still (1902), the moral control of behavior meant “the control of action in conformity with the idea of the good of all. Moral control was thought to arise out of a cognitive or conscious comparison of the individual’s volitional activity with that of the good of all” (p.1008)’ (Barkley, 1997: 4, emphasis added).

From the initial collection of an array of symptoms, AD/HD came to be defined by the three core symptoms of inattention, impulsiveness and hyperactivity. Impulsiveness in AD/HD is described as ‘deficiency in inhibiting behavior in response to situational demands’ (Barkley, 1998: 58). Symptoms such as ‘poor sustained inhibition of responding,’ ‘poor delay of gratification,’ and ‘impaired adherence to commands to regulate or inhibit behavior in social contexts’ (Barkley, 1998: 59) are ubiquitous. Barkley has concluded: ‘evidence that behavioral disinhibition, or poor regulation and inhibition of behavior, is in fact the hallmark of this disorder is so substantial that it can be considered fact’ (Barkley, 1998: 59). Inattention does not mean that AD/HDers are distractible; in fact, they are no more so than normal children. Rather, they display ‘diminished persistence of effort on sustained responding to tasks that have little intrinsic appeal or minimal immediate consequences for completion’ (Barkley, 1998: 57). They are more likely to shift ‘off-task’ to engage in play that will be more immediately rewarding. Therefore inattention is mostly observed in ‘dull, boring, repetitive tasks’ (Barkley, 1998: 57). Interestingly, ‘ADHD children spend significantly less time observing a television program when toys are available for play than do normal children’ (Barkley, 1998: 57). Hyperactivity, in turn, is characterised as follows: ‘excessive or developmentally inappropriate levels of activity — restlessness, fidgeting and generally unnecessarily gross bodily movements are commonplace — these movements are often irrelevant to the task or situation and at times seem purposeless’ (Barkley, 1998: 60).

The observation of the child’s performance in the home, school and doctor’s office or clinic is the strategy for determining the prevalence of the disorder. If symptoms are pervasive in more than one setting, and observation is concurred by multiple informants at each of these sites, then a diagnosis can be made. As will be elaborated upon later, a method of diagnosis that relies on all-pervasive observation and surveillance contributes strongly to the now extensive architecture of AD/HD.

Various etiologies of AD/HD (see Barkley, 1997, 1998; Bruer, 1999; Holowenko, 1999; Teeter, 1998) read like missions for discovering among the many symptoms a key distinguishing characteristic that can firmly establish AD/HD as a neurological disorder. Looking beyond the three core symptoms, more recent literature suggests that the key characteristic and root cause that now distinguishes AD/HD from other disorders and, of course, from normal brain functioning,5 is poor self-regulation. Gabor Maté, a well-known North American commentator on this aspect of AD/HD, writes,

completely lacking in the ADD mind is a template for order, a mental model of how order comes about. — Should you nevertheless succeed now and then, you know full well that the order is temporary. — The law of entropy rules: order is fleeting, chaos is absolute.

(Maté, 1999: 11-13)

Maté claims that an inability to determine the expressions of continuous intentions in AD/HDer’s actions is directly related to the self-circuit deficiency in the AD/HD brain, or the lack of a ‘thing’ which emanates coherent intentions/expressions via action.6 Maté states that

there is one major respect in which the specific neurophysiological impairments of ADD do hinder the development of a core sense of self and the attainment of self-esteem. It is appropriate here to speak of a sense of self, because from the neurophysiological point of view, the self-simply does not exist. There is no neurobiological ‘self-circuit’ in the brain, no little gnome pulling all the levers. What we see as the self is really a construct, akin to the optical illusion that makes us believe that a series of photographic images projected onto a screen in rapid procession are people and objects in the real world. The ‘self’ we experience is an unimaginably rapid series of firings and countless neurological circuits. ‘At each moment the state of self is constructed, from the ground up,’ writes Antonio Damasio.

(1999: 245)

Maté argues further that AD/HDers’ relation to time is intrinsically bound up with ‘self’ since ‘at each moment, the state of self is constructed'(245).7 He adds, ‘the ADD mind is afflicted with a sort of time illiteracy–or “time blindness”. — The present impulse dominates. It has been aptly said that people with ADD forget to remember the future’ (37).

The AD/HD relationship between ‘self’ and time is the nexus for Russell Barkley’s investigation of human self-control. As one of the leading AD/HD researchers in North America, Barkley has taken recent research in most interesting directions. His suggestions in AD/HD and the Nature of Self-Control can be synthesised in the following way: if self-regulation now underlies inattention, then AD/HD as a self-control deficit is closer to a pathological state. Since pathological states are variations of normal states, he sets his task as theorising normal self-control through AD/HD. Barkley begins discussing the ‘executive function’ in the brain, or that which would be the main controlling mechanism for brain processes. Many neuroscientists posit the existence of an executive function in the brain. The specific type of investigation or even positing of the hypothetical executive function varies widely, much like theories of the origin of the universe.8 Given the always already near impossibility of synthesising the particular functionings of such a ‘system’, Barkley here defines the nature of a ‘hybrid executive’ as time. The word ‘hybrid’ is used to deter the association of ‘central executive’ with the term ‘centralized’. That is, the executive is not centralized as in some well known projections about the pineal gland, but ‘central’ refers rather to the ‘main operating system’ or ‘highest laws’. I will elaborate later in this article upon some other responses to the (im)possible search for the executive function. However, it is Barkley’s use of AD/HD brain research for investigating the nature of executive functioning which interests me here.

He states that if time is the nature of the self-regulation hub (the central executive), then time is precisely what is missing in AD/HD brain functioning. Barkley elaborates on the relationship of time to self-regulation in the following way: ‘more specifically, it is the conjecturing of the future that arises out of reconstruction of the past and the goal-directed behaviours that are predicated on these activities. Such activities — permit self-regulation to time’ (1997: 202). Gross bodily movement and excessive expenditure of energy do not indicate the enactment of goal-directed behaviours (which require an understanding of and appropriate action toward the full spectrum of time) and thus suggest that in the AD/HD brain ‘time as a factor of behavioral control has been diminished’ (Barkley, 1997: 202).

The living of uni-dimensional time in multi-dimensional settings is further explained as the AD/HDer’s struggle with gaps in-between events. If there are no time delays in events and if there is no distinction between the immediate and long-term outcomes of possible responses to events, then there is no need for self-regulation. But, in ‘real’ space-time, as Barkley suggests, there are gaps in-between events and decisions have to be made. In order to be self-regulating, any ‘human’, as he says, needs a ‘cross-temporal organization of behavioral contingencies’ (1997: 54). By not submitting to the full pressures of space-time, AD/HDers do not maximise gaps in events in their lives in general (see also Guyer, 2000). Having an executive function ‘actually allows the person’s behavior to be more effectively controlled by that [multi-dimensional space-time] environment’ (Barkley, 1997: 203). Barkley makes time the central executive because time controls one’s ability to ‘make use’ of the environment, to utilise and ‘maximise’ gaps, and this is what is deemed missing in AD/HD living. Indeed, the bigger the gaps are, the more time the AD/HDer wastes. Time is somewhat like his homunculus, his little man pulling the levers, only and importantly, it is decarnated. Temporality is not located anywhere in particular. As will be elaborated upon later, the immateriality of the executive that he postulates indicates that the bodily material molded in disciplinary societies is not easily located on the terrain of what could be called contemporary control societies.

Neuroscience research such as Barkley’s constitutes the present innovative terrain of AD/HD and establishes the continuing perception of AD/HD as a ‘popularly accepted’ and a ‘mature disorder’ (Barkley, 1998: 40). This research coincides with the building of a sprawling social and popular architecture. The more AD/HD is defined and isolated in its symptoms, co-morbid relations etc., the more it is pervasive in the wider social strata through public health screening days, self-help groups, publications, official educational training and on-line groups. I suggest that the co-production of these sites has in part to do with the surveillant and spectacular nature of the diagnosis and treatment of AD/HD.

Strategies for treating AD/HD vary, but I will focus on what I have gauged by book sales and Internet popularity to be the most well received techniques for coping with the disease. There is a diverse amount of techniques for preparing classrooms, homes and even AD/HD clinics, such as keeping visual images as activity triggers posted for children, only re-arranging furniture after informing the child so that they are not too ‘disoriented,’ reminding children of important intervals in time, or teaching them what time ‘looks like’. Most of these techniques involve manipulating spatio-temporal structure in order to continuously trigger responses in the AD/HD child’s brain, where such spatio-temporal mergers cannot be sustained. I will refer to these activities as creating an ‘external brain’ (this technique is also used in Foetal Alcohol Syndrome, where there is a similar underdevelopment in the brain). Rather than addressing the particular tactics of ‘external brain’ maintenance and their specificity to teachers, administrators, parents, doctors and patients (see Cohen, 1998; Maté, Beyer et al.,1999; Dupaul and Stoner, 1994; Everett and Everett, 1999; Hallowell and Ratey, 1994; Holowenko, 1999; Teeter, 1998), I will discuss some theoretical implications of the overall strategy of monitoring and administering AD/HD in the defined settings – home, school and clinic. Below I will discuss the monitoring that must occur in each site in order for the disorder’s existence to be confirmed and managed. This is guided by the provisional question ‘where does AD/HD exist’? More exactly, on what (im)materiality does control take place? The monitoring required for diagnosis lays the network for a repertoire of possible interventions. I claim that the two instances of the discourse of AD/HD, monitoring for diagnosis and monitoring for management, constitute its largely ‘external’ or networked existence. A self-regulation network is ‘established’ because it cannot be implemented in the brain. The central and continual deviance is pin-pointed technologically in the brain yet the function or dysfunction of self-regulation is everywhere, ‘inside’ and ‘outside’, evading control. The disorder is never quite cured (except, arguably, provisionally through drugs), deviance vacuously occupies a central arena but something is maintained and contributes to the discourse of AD/HD. Spectacle and surveillance meet in a medically inscribed relation of subjectivity which does not conform with the distinctions that Foucault makes of the two. The surveillance of disciplinary society and the spectacle of pre-disciplinary society co-exist in the vacuous space left unoccupied by a self-regulating and productive individual. Some in-depth attention to Foucault will be necessary to develop this point.

The Spectacle of AD/HD

Unlike in the case of mapping the human genome, where bioethics is forecast as central to the research, within discourses of treating AD/HD it is taken for granted that there will be no ‘off-zones’ erected for the disciplining of citizens within normalizing institutions. Where is politics located in this site of child (and adult) self- and societal maintenance? Resistances (which are the modus operandi of many on-line groups) to the micro-disciplining of brains/bodies are a pervasive and transparent spectacle of one’s own, one’s child’s, neighbour’s and friend’s, brain self-regulation. If these resistances differ from the all pervasive micro-monitoring that, in the Foucauldian equation, has taken the place of the excessive spectacle of torture, how can these resistances be spoken about?

Attention to some AD/HD on-line activity will be given in the process of asking if the disorder’s discursive existence constitutes a regime of discipline and, further, if it specifically requires a Foucauldian ‘body’. Foucault investigates ‘the body’ to study neither the corporeal thing nor an abstraction but the relations of power that make it up, or ‘the instrumental coding of the body’ (Foucault, 1995: 153). Yet I would argue that Foucault still spoke of a body that is bound and constituted by a web of relations, where the two are entwined but still distinct. The following statement intimates that the body and the relations of power are still distinct moments for Foucault: ‘discipline provides — a guarantee of the submission of bodies’ (222). If bodies can be made submissive, then they also exist, somehow, pre-relationally.

Unlike in the case of Foucault’s onanistic child, the diagnosis of AD/HD is not talked about everywhere and in a secretive way, it is rather talked about everywhere and transparently.9 I have included in the endnotes a story about a video documentary on an AD/HD boy whose masturbation wipes out the rest of his world. What I wish to note here is the construction of AD/HD as an excessive expenditure of energy (without a trajectory) that must be accounted for and used to maximise the possibilities of self-control. It is important to speak here of this possibility as, ever since the demarcation of AD/HD as a neurological disorder, it has been staunchly defended against being talked about in terms of ‘cure’. Instead, discussions have been re-focused on the so-called ‘management’ of the disorder.

The transparency of the disorder lies also in the extensive public/private discourse concerning not only the ‘individual diagnosed’ but also schools, ministries of education and families. One of the reactions to the medicalisation of AD/HD is the erasure of the sole responsibility for ‘misbehaviour’ from the child ‘with problems’ and from the family ‘with no control over their child’. The diagnosis of a child or an adult can lead to ecstatic reactions or relief for finally having a cause for the chaos.10 After a diagnosis has been made, the AD/HDer is often treated with the drug Ritalin and instructed toward behaviour modification routines, such as tactics for creating an ‘external brain.’ Such a diagnosis, treatment and reaction of relief are not always but very often a public affair that is discussed extensively on the Internet and elsewhere for the neighbours to ‘see/hear’. The relief takes the form of a needed explanation among neighbours, where one’s ‘neighbours’ include those who live nearby, one’s school mates, office mates, friends, family and even oneself.11 The gesture of acknowledgement directed toward the neighbours indicates a transparency of the so-called locus of the child’s environment that is hailed again as ‘normal’. What emerges is a transparent spectacle of control with a confusing inside/outside genealogy, and not a disciplinary regime taking hold in the depths of the Foucauldian medically inscribed body. This spectacular surveillance indicates a shift from power to control that I argue can be tracked by the transformation of bodily deviance and ‘use value’ within this relation of control. The relation is characterised by the diminution of the body-in-depth and the rise of institutional architecture of a different sort, that which supports itself rather than an individual brain/body per se.12 If this is the case, then deviance is central in surveillant spectacles.

AD/HD On-Line

If modern political subjects are both produced by, and producers of, relations of powers-knowledges-pleasures-resistances, as Foucault suggests, then it is important to pay specific attention to another discursive site of AD/HD in order to continue questioning the type of bodily matter that power operates on and through, and to continue asking whether this ‘body’ is present in constructions of medical subjectivity in control societies. AD/HD on-line support groups, information sites and newsletters have been one response to the burgeoning population of people diagnosed with the disorder. Sites and groups such as ‘Scattered,’ ‘ADDed Attractions,’ ‘ADDvantage Magazine,’ ‘ADHD Research Update (addhelp@mindspring.com),’ and ‘www.hyperactiveteacher.com,‘ have been extremely active – you could even say, hyperactive.

Activists adopting AD/HD as their cause take on their and their children’s ‘life’ and its development, engagement and ensnarement in institutions. As the system has failed them, they often resort to home schooling, etc. Some take on their own management, while still continuing to battle for support from official channels and institutions.

The January 1998 e-issue of ‘ADDed Attractions’ presents a new logo for the page; the logo reads: ‘Taking Control Through Knowledge.’ Brandi Valentine, the operator of this site, offers an explanation for this change at the beginning of the e-issue. This new mission statement reflects the investment of many AD/HDers and their parents in acting amongst themselves where the school and clinical institutions had failed them. Monthly stories, resources, new research and jokes, along with professional contributions, are shared each month. The November 2001 edition offers a list of twenty-five things to do ‘When You First Find Out Your Child May Have a Learning or Behavioral Disorder’. We read there: ‘Learn all you can about the disorder named AD/HD. Buy any book by Dr. Barkley or Hallowell on the subject,’ ‘Call your state Dept. of Special Education,’ ‘Buy a small portable mini tape recorder’ to tape record conversations with school administrators about your child, ‘Start a formal diary,’ and ‘Join a web site group for parents of ADD children.’

Every month approximately 4G of data is being downloaded from Valentine’s website. There are also four thousand two hundred subscribers to a newsletter and an email discussion group of one hundred and thirty five people. Valentine also now runs a service off the web, creating a ‘Heart of the Web’ award for quality AD/HD sites that will be linked and data-based so that she can develop ‘a circle of websites that will always be helpful and useful to my readers and keep handy for readers to use’ (Valentine, 1998: non-pag.).

An example of one way in which those who are involved in the group take up ‘control through knowledge’ is the inclusion of contributions from experts every month. For example, one doctor writes in response to a request for an AD/HD test. He states that there is no ‘objective ‘ way of testing for AD/HD and explains that

when CPTs [Continuous Performance Tests] were developed there was great hope that they would provide an ‘objective’ procedure for diagnosing AD/HD. Thus, rather than relying on parent’s and teacher’s judgements about a child’s behaviour, CPTs were intended to provide an objective measure of a child’s ability to sustain attention and refrain from impulsive responding.

(Valentine, 1998: non-pag.)

Doctor David Rabiner, or ‘Dr. Dave’, as he is known on-line, goes on to say that research has indicated that these tests are not only unreliable but also very costly. So, ‘Dr. Dave’ describes a service that he offers as follows:

a simple monitoring system will keep you informed of how well your child’s ADHD symptoms are being managed, and how your child is doing behaviorally, socially and academically. You’ll know when things are going well, when they start to go poorly, and when adjustments/modifications to your child’s treatments are necessary. If you’d like to receive this, send $5.00 and a self-addressed, stamped envelope to ADHD Assessment Services.

(Valentine, 1998: non-pag.)

Taking control through knowledge is also proposed by the ‘hyperactiveteacher.com’ in his article for Valentine entitled ‘Exercising Control.’ When discussing the need to exercise AD/HD students at school more frequently than non-AD/HD students, Rick Pierce, the Hyperactive Teacher, says ‘many of our best athletes have ADD. They have used activity to self-medicate’ (Valentine, 1998: non-pag.). He stresses the importance of teacher’s active facilitation of exercise for students in the following way: ‘by keeping in mind that ADD people are seeking balance and control, we can learn to respond positively and provide options which can help them achieve balance without self-destructing’ (Valentine, 1998: non-pag.). These are only a few examples of the on-line activity of AD/HD groups whose manifesto involves ‘taking control through knowledge’ and whose activity is the production of knowledge. For a historical understanding of the medical subjectivity that ‘takes control through knowledge,’ it will now be useful to turn to Foucault.

Foucault: Birthing the Clinic

In Birth of the Clinic Foucault argues that a new clinical experience in the last years of the eighteenth century established a set of conditions which defined the ‘domain of experience and structure of rationality’ (2000: xv) which is, arguably, still with us today. By marking three changes in the spatialisation of disease, he claims that ‘a new experience of disease is coming into being’ (xv).

Foucault uses the term ‘primary spatialisation’ to discuss the procedures of disease and medicine before the end of the eighteenth century in Europe. Within primary spatialisation the essence of a disease shows itself through the body. The body is a particular instance or instantiation of the disease. The localisation of the disease in the particular body, in so far as it both reveals and conceals the nature of the disease, is a subordinate problem to how the symptoms or resemblances fit into the general classificatory system of diseases. The patient’s body makes it possible to have a body of knowledge and knowledge must constantly proceed through this body which conceals knowledge. This medical process and the type of body indicated here operate on one plane, one moment, recognition, or classification. The practice of medicine occurs as a ‘flat surface of perpetual simultaneity.’ Foucault likens the patient in primary spatialization to a portrait, presenting its flat surface as readable and assignable within a flat classificatory grid. In this pre-anatomo-clinical practice, ‘the doctor’s gaze is directed initially not towards that concrete body — but toward intervals in nature. — It is a grid that catches the real patient’ (Foucault, 2000: 8). This medical model is similar to how a portrait on canvas catches a body. Since the space of the disease is most important in this medical practice, the bodies of doctors and patients are minimalised, so that ‘in the void that appears between them, the ideal configuration of disease becomes a concrete, free form, totalized at last in a motionless, simultaneous picture, lacking both density and secrecy, where recognition opens of itself onto the order of essences'(9). Foucualt states that ‘classificatory thought gives itself an essential space, which it proceeds to efface at each moment. Disease exists only in that space, since that space constitutes it as nature’ (9). The body serves as recognition for the classificatory table because it makes visible some indications of the disease, while at the same time hiding others. While the body shows and hides the disease, the disease does not ‘exist’ in the body, discursively, but rather in the space between doctor and patient – a space of knowledge creation. The primary service of medicine is to the productivity of this knowledge-space. The patient is aided but in terms of use-value it is a by-product to this economy. I will argue that AD/HD harkens to this type of medical economy and use-value of the body, while at the same time re-introducing spectacle in the vacuous and primarily deviant space of ‘the individual’.

Foucault’s term ‘secondary spatialisation’ refers to a shift from the flat space of classes to a more ‘geographical system of masses differentiated by their volume and distance’ (10). With attempts to gauge the density of organs from corpses, to see if the pathological quality of the disease is located in them, flesh becomes a threshold. It is no longer a boundary to the doctor and to scientific knowledge but something to move beyond. Whereas previously the patient’s appearance interrupted the course of the disease, the individual now achieves a positive stature. The space between the doctor and the patient is shrunk.

‘Secondary spatialisation’

required an acute perception of the individual, freed from collective medical structures, free of any group gaze and of hospital experience itself. Doctors and patients are caught up in an ever greater proximity, bound together the doctor by an ever-more attentive, more insistent, more penetrating gaze, the patient by all the silent, irreplaceable qualities that, in him [sic], betray – that is, reveal and conceal – the clearly ordered forms of the disease.

(Foucault, 2000: 15-16)

Thus this new spatialisation of disease initiates ‘the endless task of understanding the individual’ (Foucault, 2000: 15). Foucault’s discussion of the shift in focus from disease to the individual is further elucidated by referring to the metaphor of the portrait; he states, ‘the patient is the rediscovered portrait of the disease’ (15).

What makes this shift in the manner of practice possible is the perpetual correlation of the visible and the expressible. This correlation is allowed by a ‘formal reorganization in depth — that made clinical experience possible’ (xiv). A reorganisation in depth means letting ‘thing surface to the observing gaze’ (xix). Here, the gaze becomes that which is ‘no longer reductive, it is, rather, that which establishes the individual in his irreducible quality. And thus it becomes possible to organize a rational language around it’ (xiv). Doctors have a new outline for the ‘perceptible and statable: a new distribution of the discreet elements of corporal space’ (xviii).

There also occurs a third movement which Foucault calls ‘tertiary spatialisation’. From the proximity between the doctor and the patient of ‘secondary spatialisation’ springs forth a surrounding set of institutions and practices that support and develop a medical relationship focused on the individual. Clinics, self-help organizations and their practice of tracing developments through the cases of disease, can be seen as belonging to this third spatialisation. In the following, Foucault refers generally to tertiary spatialisation as the institutionalisation of disease: ‘the medicine of individual perception, of family assistance, of home care can be based only on a collectively controlled structure, or on one that is integrated into the social space in its entirety. At this point, a quite new form, virtually unknown in the eighteenth century, of institutional spatialization of disease, makes an appearance’ (20). Institutional spatialisation constructs the ‘operating system’ for the knowledge production and bodily experience now made possible through secondary spatialisation’s interest in the individual, so that the tertiary support ‘authorize[s] a knowledge of the individual’ (18). Foucault argues that the work of these institutions is never done: ‘that the definition of the individual should be an endless labour was no longer an obstacle to an experience, which, by accepting its own limits, extended its tasks into the infinite’ (xiv).

The Order of AD/HD

Perhaps within the newer neurological discourse of AD/HD as outlined above, a discourse which provides the foundation for theories of self-control, the AD/HD ‘self’ constituted by this medical discourse is constructed in the primary service of a ‘positive disease,’ reminiscent of, yet not identical to, Foucault’s notion of primary spatialisation. Rather than being penetrated to the service of the individual’s own positive stature, ‘the individual’s’ ensnarement in the medical architecture primarily serves the construction of a positive theory of disease and, eventually, theories of self-control. Knowledge-making passes through the abnormal AD/HD body, creating scientific and popularly consumable knowledge of the disease and human self-control on its journey, but ‘the individual’ slips away. In other words, a multi-setting institutional ‘grip’ on the ‘individual’ contributes to the creation of the ‘abnormal’. However, the abnormal serves the creation of theories of disease, normalcy and self-control which operate back upon the ‘individual’. And yet, the ‘individual’ is not there as that which the disease and its technologies of abnormality can take hold of; there is a miskinesis.13 So the development of self-control is all the more pervasive but effected more in terms of management. The template for self must be managed since ‘it’ cannot be cured. The institutional spatialisation remains strong. It can perhaps be called ‘the site’ of the disorder because AD/HD’s treatment is of the order of a post-body/brain control. My brief etiology has shown how a positive disease – AD/HD – and what it yields for understanding the nature of self-control, is created. However, even though this production moves through the abnormality14 of the AD/HD, the individual – who, as Foucault suggests, the tertiary spatialization or institutionalisation of disease is build to (re)produce – slips away. Yet a familiar architecture of AD/HD remains. The monitoring in the home, school, and clinic, and the discourse’s popular existence indicate the breadth of its familiarity. For example, in the past two years, episodes of the American television shows, The SopranosThe Simpsons and South Park, that dealt with AD/HD have been produced.

Neuro-imaging technologies have located the difference between AD/HD and normal brain functioning in the right pre-frontal cortex of the brain (see Fisher, 1998; Laurence and McCallum, 1998). More pointedly, they suggest that the lack of tissue indicates a deficiency in immaterial ‘higher control processes’, the nature of which is time, in Barkley’s formulation. It seems that the deeper the instruments probe to locate the cause of AD/HD, the more it exists ‘outside’ the brain in the social environment. The more the language of the neurological existence of AD/HD is pinpointed, the more AD/HD is spread everywhere. It is precisely because something inside has been ‘found’ to be ‘not there’ (an AD/HD ability to have a neurological wiring of self) that there is not a retreat of the laser probe (or techno-scientifically enhanced grip on the ‘Inside’) but a continual Interior-monitoring with a concomitant movement Outside to establish ‘it (control)’ ‘there’ in the ‘external brain’ which is responsible for the ever receding but continually worked at possibility of individuating the AD/HDer.15 The individual is individuated via discipline, as Foucault says, and yet the individual ‘self’ at this location in the brain-scape is that which slips away and which frustrates parents, teachers and administrators alike for their inability to be regulating, generating and producing.

Technologies of the visible have sited a non-site, the site of self-control that is missing. They have sited what cannot occur inside and therefore what must occur outside, yet its possibility of being is that control operates in ‘both’. There is a blurring of the two, in the language of Deleuzian control, that actually dissolves the body that Foucault had predicated discipline on. Foucauldian ‘power’ as relational and operating on and through a material-bodily-depth and thus needing to take hold of a body/place, simply cannot operate there. There is no ‘there’ but rather a gap in the right pre-frontal cortex. Bodily matter cannot be the terrain of control that operates in this instance through insubstance or bypassing substance, and yet a sprawling architecture of disease is constructed. If discipline creates individuals, what creates undividuated masses? These masses have density and do work but their use value under this scientific and popular gaze is determined by their contribution to a ‘positive disease’. The density of the positive disease, it seems, is its tertiary modalities. Knowledge is created for use in the wider scientific neuro-community and for monitoring and development in the home, school, and clinic. Since the grip in the depth fails, knowledge of the disorder and its generation in the tertiary setting must be hyperactively produced.

The maintenance that is effected in the control of unindividuated masses is the maintenance of the institutional spatialisation of the disease. This discourse upholds the primary spatialisation of disease knowledge and classification rather than ‘the individual’. Institutional modes of AD/HD are maintained by capital’s movement through them. AD/HD may be read as a financial empire that is held in place by the sale of books, drugs and therapy, and the transactions of wrongful dismissal suits, and school negligence suits. So far I have read an economy of AD/HD which marks and attempts to manage the expenditure and waste of energy in the action/intentions of AD/HDers. I will interrogate this economy by looking at the spectacle and performance of AD/HD.

Disciplining and Punishing

In Discipline and Punish, Foucault claims that in the ancien regime, sovereignty was acted through the body. As the sovereign’s revenge on the citizen for breaking the law of the land, a body was tortured in a public display of sovereign rule. Here the economy of expenditure was of excess performance and spectacle. However, disciplinary society is marked by a transformation into a bodily economy of continuity and permanence which is achieved in the prison and in the wider social and institutional support for discipline. Once the criminal was punished; now the criminal is cured or improved. Where has the excess of torture gone? Foucault hints at but does not elaborate upon the suggestion that a trace of torture remains in the penal system. I am interested in exploring this trace of excess and suggesting how it might be bound up with a pleasure relation that is constituted in a renewed public spectacle of ‘self’ controlled and controlling ‘bodies.’ In this spectacle, ‘self’ control is exercised in front of oneself, neighbours and kin rather than the sovereign; and self-control, importantly, is ultimately evaded. I will further suggest that this spectacle indicates a post-body politics of control that is beyond the sovereign and the self in so far as the ‘brain’ or ‘body’ (supposedly housing the self) is rendered a by-product to knowledge-producing-capital’s movement through it, whereby capital produces/maintains tertiary or institutional control of, in this case, the nodes of the ‘external brain’.16 The nodes of the external brain, which offer the data for primary knowledge production, include the cost of a diagnostic test (normally not covered under health insurance or medicare and being as high as 900 dollars in the U.S.A.), seeing a doctor, Ritalin prescriptions, books, counselling, and time taken off work to be spent with children; all are costs within the observational-strategic-on-line-in home-in school-in clinic-management of AD/HD. The hyperactive managing indicates that reliable control cannot be effected permanently or even temporarily in the current and potential AD/HD ‘population’.

Foucault suggests that when a society’s ‘principle elements’ shift from community and public life to private individuals and the state, relations between the ‘principle elements’ become regulated in the reverse of the spectacle. Surveillance is the reverse of the spectacle wherein bodies are invested in as depth and captured in perpetual observation. He states ‘discipline fixes; it arrests or regulates movements; it clears up confusion’ (Foucault, 1995: 219). How are techniques of power arrested or regulated then? On what ‘surface’ (read depth) is this done? What is the material that stops disciplinary forces? Where does discipline arrest and hence, in what and what does it arrest? In Foucault’s work, the answer is ‘the body’. So discipline requires a body of depth that, through surveillance, takes the place of spectacle. The distinction that I would like to make is that surveillance does not get rid of spectacle in the case of AD/HD, not least because the monitoring that is required for the diagnosis and treatment of a disorder, which is diagnosed by symptoms, is spectacularly extensive. Spectacles from primary knowledge production and monitoring in the tertiary setting, which upholds the knowledge regime, are in place but there is little ‘individuation’ to speak of.

The Capitalist Institutional Assemblage

Foucault suggests that ‘the spectacle of public events, substitutes the uninterrupted play of calculated gazes’ (Foucault, 1995: 177). Here he uses ‘calculated gazes’ to mean techniques of surveillance that ‘hold’ the body in a relation that does not appear to be violent because the gaze is mediated by instruments that extend the eye, for example, the laser, microscope, and, presumably, PET and EEG. Since Foucauldian disciplinary society ‘substitutes’ the spectacle with techniques of surveillance, the spectacle and surveillance are distinct, sequential and non-concomitant relations or technologies. If AD/HD is a public spectacle that also relies on a play of calculated gazes, then spectacle and surveillance are co-productive rather sequential technologies. Further, observation for symptoms in a potential AD/HDer’s outward gesticulations monitors a body surface in its use rather than depth; ‘inner’, self-propelled intentions cannot be srutinized. This lack of depth required for micro-monitoring aids fulfilling capital’s telos, i.e. the eradication of material. Material is a block to value and the body becomes a by-product to capital’s movement through it whereby the nodes of the disease-knowledge economy of AD/HD can be managed. If discipline aided early capital, then control aids an advanced capital that does not need fixed things if only to pass through. Movement is the economy of capitalist control and, in this instance, it is one that decarnates.17

There were practical reasons for disseminating discipline through the public ranks because, as Foucault states, ‘when people take it on themselves, it’s a cheaper, easier and more effective social power’ (Foucault, 1995: 117). However, instead of a population being housed in a Fordian warehouse, post-Fordist populations take on their development such as it exists in multiple sites – the school, the home, the clinic. As I argue is the case with AD/HD, ‘a population’, or a massive amount of ‘subjects’ who know their bodies and their brains, and who manage their political anatomy, are formed. And yet regulation does not take hold in ‘the brain or body’ but in the ‘external apparatuses’. ‘The population’ of ‘bodies’ and their depth gripped and formed by nexuses of power relations then do not occur as such.

When the individual’s self-regulation is ever-fleeting, then public management branches and entrenches. If control is not entrenched in bodily matter then how is it maintained, if it is at all? AD/HD communities talk of a ‘right’, a ‘necessity’ for the individual to develop itself in order for it to operate ‘more fully’ in a society. But this is a society in which one is increasingly monitored with ‘performance indicators’ and assessed for our ‘value-added’ worth. Further, that ‘lifelong learning’ has recently been declared a right in Britain (Nov. 2000, Hilton Dawson) is not unconnected to the idea of the continual development of one’s economic worth. The development is based on movement, continual growth, in line with capital (therefore movement is not a priori equal to resistance against stasis or the state); the areas of developmental concern that are strongest here are the operations of the family, the school and the clinic.18 The over (but always ‘not quite well enough’) developed citizen/’individual’ ends up running the post-industrial capitalist machinery, fighting its own onanism, its wasteful, unproductive excess, in the way that leads to claims being made against the state’s inability to adequately provide for individual development. The capitalist machin(e)ations of the over-developed economies function with technological design and interaction goals of utter smoothness so that the least excessive expenditure is required to live daily, interactively. Great expense has been taken to construct a broad scientific and popular architecture to discuss, manage and control unproductive, excessive and even gross hyperactive (read ‘wasted’) brain/body movement. But this architecture never quite takes hold. Matter is lacking. Is the gross (or even net) architecture of AD/HD more excessive than the AD/HDers brain/body movements?

Post-Body Politics

Through problematising ‘power’, Foucault tracks the transformation from chains on bodies to chains on ideas and the individual itself, its ‘life’ or ‘soul.’ Individuating and disciplining a ‘life’ is not possible precisely on the soft fibres of the AD/HD brain. The brain is a space of a gapping lack of possible control. The relationship between this ever failing grip on the immaterial, mismanaging, hypothetical steerer and the administrative strategies for creating an ‘external brain’, as the therapeutic remedy for a lack of ‘executive’ function, builds an architecture with an inherent and central deviance. When Foucault states that disciplinary techniques lead to ‘a new politics of the body’ (Foucault, 1995: 103), I suggest that central deviance is a new politics of the body that can be heard when one considers the ways in which control by-passes ‘the body’. Further, this is an important consideration for contemporary readings of the biopolitical which miss this realm of control and deviance when they pressume that their measure is a body-of-depth.19

As a transformation in spectacle, AD/HD speaks to the brain’s and body’s (im)material significance regarding control. That (im)material significance is the root of deviance and is what remains, even though self-control is evaded or fleeting. Russell Barkley states that, by operating in three- rather than four-dimensional space-time, AD/HDers are evading control or ‘executive’ functioning. They do not let themselves control (for the matter of ‘being/controlled’ is neurologically not possible), in so far as they experience a limited capacity to recognize the diffuse ‘operating system’ and act accordingly, futurally. Treatment through time awareness leading to the efficient filling of gaps in daily production/activity would mean operating in fuller ‘reality’. This would leave the AD/HDer more capable to live a self-regulating life but never permanently fixed and always initially deviant. The terms on which a statement of ‘self-controlled life’ can be made need to be questioned as they just might be the (im)material tools of control. What I am advocating as biopolitics is a search for tools in this case rather than, necessarily, for bodies or brains.

Banishing the Homunculus

Non-domain specific control recalls the most recent proceedings from the Eighteenth International Symposium on Attention and Performance (1998), which indicates a very different turn from the search for ‘central executive’ function in the brain. The theme for the symposium was ‘Control of Cognitive Processes: Banishing the Homunculus’ or little man, manikin. In the introductory chapter to the proceedings, Monsell and Driver relentlessly criticize the search for ‘executive’ function in the brain and indeed mark the conference and these proceedings as a significant international shift away from the ‘executive’ function search to a decentered analysis of ‘higher’ control processes. They favour work on complex systems that are flexibly controlled with no identifiable controller so strongly that they suggest ‘perhaps our slogan should be, not “Banish the Homunculus!”, but “Dissolve, deconstruct, or fractionate the executive! Let a hundred idiots flourish!”‘ (Monsell and Driver, 2000: 7). Distributed, dissolve, deconstruct; all the trendy ‘D’ words without the ‘D’ names that we site with them.

Monsell and Driver, as the spokespeople for an international community of attention and performance neuroscientists of which three are AD/HD specialists, disregard questions of ‘nature, unity, substrata of consciousness’. They favour searching for a neuro-substrata of control or that which has the effect of sculpting intentions rather than attempting to find a sculptor. To research this they suggest ‘it is perhaps better first to model control functions from the “outside”, and only then to worry about how they relate to what control or lack of control feels like from the “inside”‘ (2000: 8). Inside and outside are used in inverted commas as they are interested in the functionality of control rather than locationality. Monsell and Driver begin researching ‘externally’ but they are interested in how control moves between inside and outside rather than where it might rest. What is of interest to them is not what is controlled but how control is exercised. They call for work not only on non-centralized control, as in a ‘central executive’, but on non-domain specific control – meaning not multilocated or dislocated, but unlocated, which includes the possibility of locating control anywhere. That is to say, they wish to research mislocated control that is distinct from the resources ‘it’ controls.

They suggest that new research aided by neuro-imaging technologies makes it possible to postulate an executive systemrather than function; a system ‘with interdependent and interacting parts’ (2000: 27). One research direction into such a system for AD/HD is Barkley’s ‘working memory’. Barkley invokes internet terminology in the possibility of having an ‘on-line’ memory that would supply information about the past and future that can be held ‘on-line’ to help carry out responses or tasks. ‘The provisional or working memory system’ (Barkley, 1997: 182) would aid in interpreting and carrying out intentions in an environment which is temporarily lacking ‘events’. It would provide an on-line, overall time executive in order to live productively, futurally. This very recent work can be read as attempts to respond to a crisis of the organism and of the ‘how’ of control when control cannot be located. AD/HD is couched in this discourse wherein the goal is to manage without a centrally-controlled organism. In terms of political theory, this can be read as a crisis of governmentality when the head of the king is not only cut off but running about and off at the mouth. This story suggests that decarnating is how one particular post-‘individual-state’ relation, an economy of movement, is maintained within a renewed spectacle of social and self maintenance. Hence mis-kinetic neuro-politicology.


When a brain cannot be cured, multifarious medical, educational and social networks, administrations, groupings, documents, etc. become the regulation of AD/HD. When the ‘individual’s’, ‘society’s’ and the ‘medical-educational institutions” primary concern is the maintenance of an ‘external brain’, where is ‘the body’ as Foucauldian evidence of the operations of relations of power in institutions of normalisation? Foucault states that ‘control and transformation of behaviour come about with the development of a knowledge of the individual’ (Foucault, 1995: 125). The case of AD/HD suggests a shift in the order of things wherein the medicalised grip on the individual is displaced by the disease/disorder and ‘the population’s’ relation to the disease. The disease does not take hold of the individual, nor do the symptoms, as the neurological research on AD/HD suggests, indicate an individual.20 The broad architecture of AD/HD that is performed, and in some cases contributes to the discovery of the nature of self-control, suggests that there is a new will to knowledge about the essence of disease that recalls Foucault’s primary spatialisation of medicine, wherein the individual instances of the disease are a dispossable by-product to the general knowledge garnered from it.

The sources studied here, neuroscience and popular on-line AD/HD literature, are productively related. Evidence that research labs started sharpening their pencils toward creating knowledge or behaviour monitoring mechanisms that could be used in other AD/HD locales is prominent. One researcher states, ‘greater emphasis was also given to developing direct behavioural observation measures of ADHD symptoms that would be taken in the classroom or clinic’ (Barkley, 1998: 30). At these sites, teachers, doctors, peers, kin, self, friends, all monitor for symptoms. In an individually-vacuous architecture where anybody, including Bart Simpson, Junior Soprano or Cartmen, could be AD/HD, spectacle re-emerges but it is morphed into surveillant spectacles of continual ‘self’-controlling attempts. There is little disciplinary individuation occurring so the architecture of disease, in its ‘positive’ becoming, is even more hyperactively developed.21 Only a disease/disorder operating in this primary mode of spatialisation can diffuse its essence onto the polyvalent institutionalisations of discipline, or rather, control, and yet leave unattended a pin-pointed causal brain-terrain, unihabitable to the individual, as its deviant foundation.

Many thanks to Scott Wilson, Mick Dillon, Paul Fletcher, Paolo Palladino and particularly Joanna Zylinska for their comments and suggestions on a number of drafts of this paper and to the participants and attendees of the panel at the International Interdisciplinary Conference ‘Cultural Studies: Between Politics and Ethics’ (Bath Spa University College, 6-8 July 2001), where this paper was presented.


1 Different commentators and doctors use varying forms of abbreviation for the disorder(s) to distinguish between Attention Deficit Disorder with or without hyperactivity; I have chosen to use AD/HD throughout my article to indicate that I am referring to both variants of the disorder. I will also be referring mainly to literature about AD/HD in children in the follwing pages. Also, it has been suggested that the ‘epidemic’ of AD/HD in North America is largely a middle- to upper-class phenomenon. For example, in Canada, East and West Vancouver are divided very strongly along class lines. So discussions in West Vancouver of an ‘AD/HD epidemic’ cannot be easily mapped on to East Vancouver, where the neurological health challenges faced by children are different.

2 That a large part of political life is currently constituted on the terrain of the biopolitical is argued by theorists such as Agamben, Foucault, Haraway, and Virilio. For the purposes of this paper, a recent statement by Negri and Hardt can suffice as an explanation of the biopolitical. They state, ‘the struggles are at once economic, political, cultural – and hence they are biopolitical struggles, struggles over the form of life. They are constituent struggles, creating new public spaces and new forms of community’ (Negri and Hardt, 2000: 58).

3 For example, in Empire, Negri and Hardt refer to the biopolitical as being a realm of ‘depth’ as in the phrase: ‘throughout the unbounded global spaces to the depths of the biopolitical world’ (2000: 26).

4 According to the World Health Organisation’s International Classification of Diseases (ICD), ‘”Disorder” is not an exact term, but it is used here to imply the existence of a clinically recognizable set of symptoms or behaviour associated in most cases with distress and with interference with personal functionings’ (WHO in Bolton, 2001: 183). The problematic separation between mental and physical disorders that would map onto AD/HD’s classification is expressed in the Diagnostic and Statistical Manual of Mental Disorders; ‘a compelling literature documents that there is much “physical” in “mental” disorders and much “mental” in “physical” disorders. The problem raised by the term “mental” disorders has been much clearer than its solution, and, unfortunately, the term persists in the title of DSM4 because we have not found an appropriate substitute’ (DSM4 in Bolton, 2001: 183).

5 Foucault writes ‘once you recognize normal and abnormal, you can claim the honour of curing’ (Foucault, 1995: 304). However, AD/HD is not something that is cured but continually managed. I will elaborate on this distinction in the following pages.

6 The AD/HD experience of ‘self,’ ‘other,’ and the boundaries between them seems to diverge from the ontological prerequisites of liberal individualism in so far as the modern liberal is constructed by conclusions about spatio-temporal relationships that do not seem to be recognizable to AD/HDers.

7 Hallowell and Thompson also state that ‘[i]n ADD, time collapses. Time becomes a black hole. To the person with ADD it feels as if everything is happening all at once. This creates a sense of inner turmoil or even panic. The individual loses perspective and the ability to prioritize. He or she is always on the go, trying to keep the world from caving in on top (Hallowell and Thompson, 1997: 88).

8 In the acknowledgements to his book, Barkley places his and his colleagues’ search for a theory of self-control via AD/HD in the perspective of human evolution. He expresses his indebtedness to Jacob Bronowski, ‘the late British scientist, mathematician, poet, and lifelong student of human evolution’ (Barkley, 1997: xiii) and television presenter on ‘The Ascent of Man.’ Thanks to his predecessors, Barkley is able to attempt to ‘synthesise a theory of executive functions and their critical role in human self-regulation’ (Barkley, 1998: vii).

9 One example is the way in which an AD/HD boy’s masturbation is discussed openly and even filmed in a documentary about AD/HD entitled Around the Clock: Parenting the Delayed ADHD Child by Goodman and Hoban. Along with other examples of the boy not being ‘on task’ throughout the day, his mother remarks ‘one summer David discovered masturbation to an extreme so that the rest of his world was wiped out’ (Goodman and Hoban, 1994). As the dialogue rolls, the camera enters the boy’s room and ‘catches him’ on his stomach, masturbating. The camera stays filming the boy for a number of seconds. That this activity was discussed in the context of his general wasted expenditure throughout the day is significant and resonates of Foucault’s discussion in the History of Sexuality V.1 but also in Discipline and Punish, where he states ‘in the correct use of the body, which makes possible a correct use of time, nothing must remain idle or useless: everything must be called upon to form the support of the act required. A well disciplined body forms the operational context of the slightest gesture — a disciplined body is the prerequisite of an efficient gesture’ (Foucault, 1995: 152). Much of the dismay of teachers and parents is derived from the seemingly vectorless waste of energy in the activities of the AD/HD child. At another point in the video, David’s mother remarks, ‘we have to extend our imagination to him, ‘cuz it’s not coming naturally to him — none of the daily routines are accomplished easily’ (Goodman and Hoban, 1994).

10 See http://www.scattered.com for testimonials of eureka moments.

11 Holowenko has argued that ‘with more children now being identified with AD/HD it has become increasingly important for teachers and other professionals working with these children to acquaint themselves with the nature of this condition. Furthermore, there is a need for a multi-modal collaborative approach to the assessment and intervention process – one which involves parents, teachers, psychologists and medical practitioner working together’ (Holowenko, 1999: 12). This requires a multidisciplinary approach to both monitoring for diagnosis and intervention for treatment. I will suggest that diagnosis by observation in multiple domains or settings establishes a persistent, spectacular intervention network as well. The types of on-line intervention and the disease’s ‘popular life’ suggest that there is a strong relationship between spectacle and monitoring. This confuses the distinction that Foucualt has made between the two and, possibly, between discipline and control.

12 Another example of the openly discursive phenomenon of AD/HD is the ease with which parents hand over Ritalin prescriptions with instructions to summer camp co-ordinators and teachers. I have heard of one teacher and one summer camp co-ordinator who both, having the reponsibility of handing out Ritalin tablets to children, felt ‘like pharmaceutical dispensers’.

13 A directed, intended ‘dis’ or counter-movement is not made to elude the home, school, and clinic establishments. I use miskinesis however to refer to a central ‘mis’ and, in Deleuzian terms, possibly foundational (mis)movement to this control regime; this is to be distinguished from resistance which tags along the various sides of power relations.

14 It is important to say abnormality and not ‘abnormal body of AD/HD’, for it is abnormality, and not the individual abnormal body’s showing up through the discourse of AD/HD, that indicates a primary spatialisation and a decline or fissure in the story of the medical ‘individual’.

15 The relation between the ability ‘to see’ the inside and control operations in smooth spaces such as the filmic ones of MRIs, EEGs and PETs, can also be demonstrated by a history of the role of the visual in the construction of the brain (in military attention experiments) and then the AD/HD brain (see Laurence and McCallum, 1998).

16 Evidence of this move ‘outside’ and the primary significance of AD/HD bodies as by-products that hold up these institutional forces, can be found, for example, in diagnosis. The power and changing function of visualisation here is significant for the double moves that occur in the inside findings and outside control. Initially AD/HD was diagnosed via symptoms, and it still is. (Even though there is now the technology to determine this neurological underdevelopment, it cannot be administered to all.) However, the technology has made the understanding change. The site of, or existence of, AD/HD was in the muscles (in their attachment to the brain or executors of the brain will), for which the outwardly affects are visible – one could see the irregular and erratic movement, e.g. the mouth moving faster than average (see Cartwright, 1995). Now that its ‘real location’ is invisible (made visible to professional interpreters) and yet exists somehow more concretely as in the pre-frontal cortex, the discourse around diagnosis and treatment of AD/HD is more widespread. Having AD/HD visibly exist in something previously invisible – rather than visibly on the skin’s movements – makes it actually more concrete in patients’ apprehension and empowerment. This can be argued through the way in which groups and authors working on AD/HD healing have employed images of the brain taken from neuro-imaging technologies.

17 The term ‘post-body’ does not suggest that there isn’t a thing that we inhabit and breath through, but questions the significance that thing has through tracing its use in contemporary celluloid formations. This reflects a shift in focus from the Foucauldian body as a density of relations of powers-resistances-knowledges-pleasures to these nexuses.

18 This same argument that Foucault’s notion of relations of power is predicated on a body that can be outside these relations can be made another way. This body is apparent in two ways: (1) the body (above) (2) a body of knowledge that ‘the body’ helped create as centralized and accumulated (Foucault, 1995: 231). These two ‘bodies’ refer back to each other. In an information society (see Virilio, 1986; Baudrillard, 1993) centralized, accumulated knowledge is no longer the principle of formation or even the principle formation. Rather than being used for the central accumulation of knowledge, the body’s value is in how much information, money, consumable goods etc. it can pass through itself. Similarly, recent commentators on the Human Genome Project and post-genomics (Kay, Haraway, Rabinow) have argued that there is a shift in the order/power of knowledge occurring with new technologies that allow the manipulation of ‘life itself’. ‘Knowledge of what things are’ is less important than ‘an ability to do things with them’ (Sarah Franklin, recent dialogue). In reference to these scientific moments, it is said material is only important in so far as it can be used. In ‘The Spectral Ontology of Value,’ Christopher J. Arthur states that capital does come to rest (this is not to argue that there is an eradication of ‘things’) but the activity of it is is what is important in the thing rested on; or it ‘presents the process in its product’ (Arthur, 2001: 41); ‘capital speaks through them only of its own concerns’ (Arthur, 2001: 40). This argument has significant resonances with what I have said here about the transformation of the AD/HD body-product into a by-product.

19 In his notes on control societies Deleuze suggests that Foucault spoke about movements away from disciplined confinement and toward control societies wherein ‘discipline’ is dispersed through the dissolving walls of institutions to where it operates in more open spaces of everyday social life. In these less confined spaces, control operates as a stronger developmental force such as in continual training and continual monitoring in the school, workplace, hospital, and military. Reform is the motor of control-based systems, while communications apparatuses are its tools.

20 Why is there nothing to take hold of? One cannot read an individual disposition or intention upon the AD/HD ‘individual’. In non-ADDers, act or action is explained as a symptom of expression or a projected intention, part of an unfolding telos. The expression of the act refers back to the expression and intentions of something. Or, as Bolton states, ‘what are at hand in the clinic, plausibly, are the criteria of mental disorder involving breakdown of intentionality, using notions of normality and abnormality (and their cognates)’ (Bolton, 1999:199). In order for actions to be understood in this way, there must be a central source from which intentions have arisen. If the executive function which individuates and regulates is missing, what does the ‘normalisation’ of these AD/HD bodies take hold of?

21 In Postscript on Control Societies Deleuze suggests that in the hospital system ‘the new medicine “without doctors or patients” that identifies potential cases and subjects at risk and is nothing to do with any progress toward individualizing treatment, which is how it’s presented, but is the substitution for individual or numbered bodies of coded “dividual” matter to be controlled’ (Deleuze, 1995: 182). Foucault states that in the ancien regime, criminals were made to feel the horror of their crimes by being offered an image of it in their punishment. Now, images of ‘the brain’ are used on many AD/HD community websites to empower and elicit self-control ‘through knowledge’. These images are gleaned from neuroscience technologies and texts which sign the seal on the irreversibility of the disorder. Does a pleasurable excess of torture remain in precisely this self and societal surveillance of control? The spectacle of continual management indicates a pleasure and deviance that is perhaps a trace of torture moving through and beyond bodily and disciplinary boundaries.


Arthur, C. J. (2001) ‘The Spectral Ontology of Value’, Radical Philosophy 107.

Barkley, R. (1997) ADHD And the Nature of Self-Control. New York, London: The Guilford Press.

— (1998) Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, Second Edition. New York, London: The Guilford Press.

Baudrillard, J. (1993)Symbolic Exchange and Death. Trans. M. Gane. London: Sage Publications.

— (2000) Simulacra and Simulation. Trans. S. F. Glaser. Ann Arbor: The University of Michigan Press.

Bolton, D. (2001) ‘Problems in the Definition of “Mental Disorder”‘, The Philosophical Quatterly v. 51, n. 203.

British Columbia Ministry of Education, Skills and Training (1997) Teaching Students with Attention-Deficit/Hyperactivity Disorder: A Resource Guide for Teachers. Victoria, B.C.: Queen’s Printer for British Columbia.

Bruno, G. (1992) ‘Spectatorial Embodiments: Anatomies of the Visible and the Female Bodyscape’, Camera Obscura. v. 28: 239-261.

Beyer, W. et al (eds) (1999) Born to Be Wild: Attention Deficit Hyperactivity Disorder, Alcoholism and Addiction. Judy Wood Publishing Co.

Bruer, J.T. (1999) The Myth of the First 3 Years: A New Understanding of Early Brain Development and Lifelong Learning. New York: Free Press.

Cartwright, L. (1995) Screening the Body: Tracing Medicine’s Visual Culture. Minneapolis: Minnesota University Press.

Cohen, M. (1998) The Attention Zone: A Parents’ Guide to Attention Deficit/Hyperactivity Disorder. Washington, DC: Brunner/Mazel, member of the Taylor & Francis Group.

Connolly, W. (1999) ‘Brain Waves, Transcendental Fields, Technologies of Thought’, Radical Philosophy 94.

Deleuze, G. (1991) Bergsonism. Trans. H. Tomlinson & B. Habberjam. New York: Zone Books.

— (1995) Negotiations 1972-1990. Trans. M. Joughin. New York: Columbia University Press.

— & Guattari, F. (1987) A Thousand Plateaus. London: Continuum International Publishing Group, Athlone Press.

Dupaul, G.J. & Stoner, G. (1994) ADHD in the Schools. New York: Guilford Press.

Everatt, J. (ed.) (1999) Reading and Dyslexia: Visual and Attentional Processes. London: Routledge.

Everett, C. A. & Everett, S.V. (1999) Family Therapy for ADHD: Treating Children, Adolescents and Adults. London: Guilford Press.

Fisher, B. (1998) Attention Deficit Disorder Misdiagnosis. CRC Press.

Foucault, M. (1990) History of Sexuality V.1: An Introduction. Trans. R. Hurley. New York: Vintage Books.

— (1970) The Order of Things: An Archaeology of the Human Sciences. Trans. R.D. Laing. New York: Vintage Books, A Division of Random House.

— (1980) Power/Knowledge: Selected Interviews and Other Writings 1972-1977 (edited and translated by C. Gordon et al.). New York: Pantheon.

— (1995) Discipline and Punish: The Birth of The Prison. Trans. A. Sheridan. New York: Vintage Books.

— (2000) The Birth of the Clinic: An Archaeology of Medical Perception. Trans. A. M. Sheridan. London: Routledge.

Goodman, J.F & Hoban, S. (1994) Around the Clock: Parenting the ADHD Child. Video. New York: Guilford.

Guyer, B. P. (ed.) ADHD: Achieving Success in School and in Life. London: Allyn and Bacon.

Hallowell, E. M. & Thompson, M. G. (1997) Finding the Heart of the Child: Essays on Children, Families and Schools.Washington, D.C.: National Association of Independent Schools.

Hallowell, E. M. & Ratey, J. J. (1994) Driven to Distraction: Recognizing and Coping with Attention Disorder from Childhood Through Adulthood. New York: A Touchstone Book, Simon and Shuster.

— (1996) Answers to Distraction. New York: Pantheon Books.

Holowenko, H. (1999) Attention Deficit/Hyperactivity Disorder: A Multidisciplinary Approach. London: Jessica Kingsley Publishers.

Hardt, M. & Negri, A. (2000) Empire. London: Harvard University Press.

Hinshaw, S. (1994) Attention Deficits and Hyperactivity in Children V. 29 Developmental Clinical Psychology and Psychiatry Series. Thousand Oaks: Sage.

Laurence, J. & McCallum, D. (1998) ‘The Myth-or-Reality of Attention Deficit Disorder: a Genealogical Approach’,Discourse: Studies in the Cultural Politics of Education. v. 19, n. 2.

Logan, G.D. et al. (2000) ‘Executive Control Problems in Childhood Psychopathology: Stop Signal Studies of Attention Deficit Hyperactivity Disorder, in S. Monsell & J. Driver (eds), Attention and Performance XVIII: Control of Cognitive Processes (based on papers presented at the 18th International Symposium on Attention and Performance, Windsor, Berkshire, England. July 12-18, 1998). Cambridge: The MIT Press.

Martin, E. (2000) ‘Notes on AD/HD’, Cultural Values v. 2, n. 2.

Massumi, B. (1996) ‘The Autonomy of Effect’ in P. Patton (ed.), Deleuze: a Critical Reader. London: Blackwell.

Maté, G. (1999) Scattered Minds: A New Look at The Origins and Healings of Attention Deficit Disorder. Toronto: Alfred A. Knopf.

Monsell, S. & Driver, J. (eds) (2000) Attention and Performance XVIII: Control of Cognitive Processes (based on papers presented at the 18th International Symposium on Attention and Performance, Windsor, Berkshire, England. July 12-18, 1998). Cambridge: The MIT Press.

Segal, L. (2001) ‘It’s Different for Boys’, The Guardian G2 Section (March 07).

Teeter, P.A. (1998) Interventions for ADHD: Treatment in Developmental Context. London: The Guilford Press.

Valentine, B. (1998) ‘ADDed Attractions’, special issue of ADHDNews.comhttp://adhdnews.com/jan98.htm

Virilio, P. (1986) Speed and Politics. Autonomedia.

— (1995) Art of the Motor. Trans. J. Rose. Minneapolis: University of Minnesota Press.

Wagonseller, B. et al. (1998) A Teacher’s Fix-It-Yourself ADHD Manual. United Learning.

Weingartner, P. (1999) Adhd Handbook for Families: A Guide to Communicating with Professionals. Child Welfare League of America.