Received: 11 December 2017 Revised: 3 September 2018 Accepted: 6 December 2018

DOI: 10.1111/jtsb.12198

ORIGINAL ARTICLE

Adult women and ADHD: On the temporal

dimensions of ADHD identities
Paul Stenner1 | Lindsay O'Dell2 | Alison Davies2

1
School of Psychology, Open University,
UK
Abstract
2
Open University, UK
This paper uses conceptual resources drawn from
psychosocial process thinking (Brown & Reavey, 2015;
Correspondence
Brown & Stenner, 2009; Stenner, 2017) and from G.H.
Paul Stenner, School of Psychology, Open
University, UK. Mead in particular, to contribute to an emerging body
Email: paul.stenner@open.ac.uk of work on the experiences of adult women with
ADHD (Horton‐Salway & Davies, 2018; Quinn &
Funding information
British Academy/Leverhulme Small, Madhoo, 2014; Singh, 2002; Waite & Ivey, 2009). It
Grant/Award Number: SG142625 has a particular focus on how ADHD features in the
construction of women's identities and life‐stories and
it draws upon findings from a qualitative investigation
of adult women diagnosed or self‐diagnosed with
Attention Deficit Hyperactivity Disorder (ADHD). A
theoretically informed ‘thematic decomposition’ of 16
depth interviews reveals how complex processes of
identity transformation are mediated by the social cate-
gory of ADHD. Through this process, troubled pasts are
reconstructed from the perspective of an ‘emergent’
identity that offers participants the potential for a more
enabling and positive future.

KEYWO RDS
attention deficit hyperactivity disorder, emergence, G.H. Mead,
gendered identity, identity change, qualitative research, self‐diagnosis,
temporality

1 | INTRODUCTION

This paper uses conceptual resources drawn from psychosocial process thinking (Brown &
Reavey, 2015; Brown & Stenner, 2009; Stenner, 2017) and from G.H. Mead in particular, to
contribute to an emerging body of work on the experiences of adult women with ADHD

J Theory Soc Behav. 2019;1–19. wileyonlinelibrary.com/journal/jtsb © 2019 John Wiley & Sons Ltd 1
2 STENNER ET AL.

(Horton‐Salway & Davies, 2018; Quinn & Madhoo, 2014; Singh, 2002; Waite & Ivey, 2009). It
has a particular focus on how ADHD features in the construction of women's identities and
life‐stories. Although potentially relevant to a broader literature on mental health, gender,
memory and diagnosis (see Cromby, Harper, & Reavey, 2013), the paper responds to four spe-
cific developments:

1. Growing numbers of people are accommodating the category of ADHD into their identity as
the extent of ADHD diagnosis is rapidly increasing, both amongst children (Hamed, Kauer,
& Stevens, 2015 estimate up to an 11% prevalence rate totalling at around 6.4 million chil-
dren with ADHD in the USA alone) and adults (Barkley, 2015; Weyandt & DuPaul, 2006);
2. Research to date has been dominated by a focus on children and on male children in
particular, with more boys than girls being diagnosed by ratios up to 10/1 in clinical settings
(Williamson & Johnston, 2015);
3. Recent years have seen a large increase in the number of adult diagnoses, and within this,
women's rates of diagnosis are notably increasing, such that the gender prevalence ratio
narrows markedly with age. According to Williamson and Johnston (2015), the gender
gap of a 10/1 ratio of boys to girls narrows to 2.73/1 amongst adults. They also indicate that,
compared to men, women are more likely to be diagnosed with ADHD as adults, suggesting
a subset for whom any childhood ADHD went undiagnosed. This raises questions
concerning the processes through which ADHD is recognised by or for such women, and
the impact this recognition may have upon their lives;
4. Although not all who meet the diagnostic criteria claim ADHD as an identity, there has
been a growth in the number of women who have identified sufficiently with the category
of ADHD to self‐diagnose (Conrad & Potter, 2000). This may relate to what Williamson and
Johnston (2015, p.23) describe as ‘higher rates of treatment seeking for adult women com-
pared to men’, but it is also possible that some women who self‐diagnose are not motivated
to go on to secure a formal diagnosis. Either way, the question of why and how women ‘self‐
diagnose’ (whether or not they go onto a formal diagnosis) is of particular interest given the
context described above.

In DSM‐5 ADHD is defined as a pattern of inattention that may or may not include impul-
sivity/hyperactivity. The symptoms of inattention need to have been persistently present in
two or more settings (e.g. home/school/work) since before the age of 12, interfering negatively
with functions expected in those settings. DSM‐5 updated the definition in the prior manual
because this was deemed biased towards the symptoms of children compared to adolescents
and adults. According to Williamson and Johnston (2015, p. 22) ‘the diagnostic criteria for
ADHD were largely developed from samples of male children’ (see also Bailey, 2014; Waite &
Ivey, 2009), but it is now recognized as a life‐span issue. Research on adult ADHD has
mushroomed, with over 50% having been published in the last 5 years (Williamson and Johnson,
2015, Barkley, 2015).

1.1 | Identity and identification with ADHD

The trends described above raise important questions about how and why adult women come to
identify themselves as having ADHD. Unfortunately, Schott (2012, p.11) describes the literature
on the identity development of adults with ADHD as ‘dismal’, and studies on the actual process
STENNER ET AL. 3

of ADHD diagnosis were described by McHoul and Rapley (2005, p.446) as ‘almost non‐
existent’. Despite the possibility of stigma (Wiener et al., 2012), according to Brady (2004), the
diagnostic category can provide a framework for newly understanding a child's behaviour and
situation (Radcliffe, Sinclair, & Newnes, 2004), and, in the case of children's diagnosis, is often
triggered via the education system. Whilst some women will have been diagnosed in childhood,
others come to identify with ADHD only as adults. The process of diagnosis is less clear with
adults, and the relevance of identity is likely to play out very differently (Weyandt & DuPaul,
2006). Self‐diagnosis is particularly worthy of attention because, for many, ADHD falls
into the category that Dumit (2006) describes as ‘illnesses you have to fight to get’. In
situations where people aim to get diagnosed, questions of identity (especially processes of
self‐identification with the diagnostic category) are likely to be important.
Identity, in basic terms, is a dialogical phenomenon (Hermans and Hermans‐Konoptka,
2012): it is the response someone gives to the question ‘who are you?’ At a more complex level
it is related to the theory a person develops about who and what they are amidst an ongoing
stream of positioning and counter‐positioning (see Wetherell & Mohanty, 2010). That theory –
simultaneously personal (and pertaining to ontogenesis) and social (implicated in sociogenesis)
‐ is both dialogical, and ongoingly revised (Gillespie & Cornish, 2010). As the latter authors
point out, identity is as much about being identified as about making self‐identifications
(Duveen, 2001). Identity is thus a relational process, not a state, and yet it serves as the source
of a grounding attachment or commitment to how things ‘are’.
ADHD becomes part of a person's identity when it features as an aspect of their self‐descrip-
tions and self‐concept (Shames & Alden, 2005). One classic approach relevant to the current
topic seeks to explain increases in diagnosis by linking identity to ‘medicalization’. This
approach construes identity rather passively, emphasising the ‘being identified’ aspect more
than the making of self‐identifications. Medical categories like ADHD are criticized for being
part of techniques of social control which use powerful drugs to manage otherwise disruptive
conduct and to impose new ‘medicalized’ identities on people, particularly schoolboys (Lloyd,
Stead, & Cohen, 2006). This approach offers a sociological explanation for high prevalence rates
in the schools of North America, Australia and the UK (Malacrida, 2004). The medicalization
thesis presupposes a resistant population who are unlikely to personally embrace the diagnosis,
although Ilina Singh has found that mothers of ‘medicalized’ children may find an ADHD diag-
nosis ‘very welcome’ (Singh, 2002, p. 593, see also Brady, 2014). This approach, however,
becomes less plausible in situations where people appear to actively seek out an ADHD diagno-
sis for themselves, and this latter scenario is therefore of particular interest.
Other work dealing with identity takes an equally skeptical view of people's motives for
ADHD diagnosis. In the US, for example, where diagnosis has direct implications for health
insurance, Conrad and Potter (2000, p.574) suggest that individuals ‘who, prior to diagnosis,
would not have seen themselves having a disability find themselves reaping the benefits of dis-
ability legislation’. Comparable arguments have been raised about the self‐interested benefits of
pharmaceutical companies who benefit from relaxations of the formal criteria for diagnosis
(Conrad & Potter, 2000, p.573). Another argument focuses on the possibility that ADHD diagno-
sis might be desirable to some because its treatment by drugs can enhance people's abilities to
concentrate and perform intellectual tasks. In discussing adult ADHD, Conrad and Potter sug-
gest that ‘medication treatment may be seen as much as an enhancement as a form of social
control’ (2000, p. 575).
Comstock (2011) points out that these kinds of efforts to explain the construction of an
ADHD identity imply that the ‘ADHD individual’ is either manipulated by powerful others
4 STENNER ET AL.

using partial knowledge, or acts in bad faith with respect to knowledge about ADHD for per-
sonal gain. Although he does not provide data, Comstock suggests that this ‘negative relation
to knowledge’ can misrepresent how people creatively grapple with knowledge around ADHD
to ‘positively make sense of their lives and behaviors in nontrivial ways’. Without denying that
social control or benefits may occasionally play a role in diagnosis, he adopts a broadly
Foucaultian perspective and asks for a deeper understanding of the complexities at play in an
ADHD identity.
This study aims to provide a theoretically informed empirical understanding of the
processual complexities of identity formation and change. The interest is in examining how
women make sense of ADHD from their own perspective, but with particular attention to the sit-
uated temporal dynamics of identity change. A main point of interest is thus in deepening
knowledge of the temporal aspects of ADHD identities. To make this empirical contribution,
however, it is necessary to briefly articulate a process theoretical approach able to grasp the tem-
poral dimensions of identity‐as‐process. To this end we draw upon G.H. Mead (1932/1980)
whose version of ‘process thought’ was directly influenced by the process philosophies of Henri
Bergson and A.N. Whitehead. There is a growing interest in process thought within psychology
(Stenner & Weber, 2018), and Mead's is just one of several important contributions. To give just
two inspiring examples, Brown and Reavey (2015) draw upon Bergson, Deleuze and Kurt Lewin
to explore the processual dynamics at play when ‘living with a difficult past’, whilst Zittoun and
Gillespie (2015) modify sociocultural psychology and social representations theory using
processual ideas from William James, C.S. Peirce and others to illuminate the temporality of
biographies. Hence we do not claim that Mead's work is of singular theoretical importance,
although, like that of Lewin, it is relevant for present purposes because it is squarely located
within social psychology.
There are ‘many Mead's’ (Gillespie, 2005), but he is best known ‐ via the symbolic
interactionism of Blumer (1980) ‐ for his social theory of role‐taking whereby we ‘must be others
if we are to be ourselves’ (Mead, 1980: 194). For Mead, the emergence of the human self was a
decisive and unique moment in animal evolution: ‘the self that is central to all so‐called mental
experience has appeared only in the social conduct of human vertebrates. It is just because the
individual finds himself taking the attitudes of the others who are involved in his conduct that
he becomes an object for himself. It is only by taking the roles of others that we have been able
to come back to ourselves’ (Mead, 1980: 184). From this perspective, self‐identity and society
presuppose each other because the meaningful social acts that compose the activities of a com-
plex human collective could not be coordinated but for the evolutionary emergence of human
selves. Furthermore, by definition the human self cannot be treated as something self‐contained
and shut up, as it were, within its own world, and neither can it be treated as something that
can exist within any isolated instant of time: the self is always something in passage (both from
one perspective to another, and from one occasion to another). Because the self is always a syn-
thesis‐in‐process that is mediated through the perspectives of others, so we humans often find
ourselves swept up in what Mead calls ‘the passion of self‐consciousness’ (194) whereby we
‘approve of ourselves and condemn ourselves. We pat ourselves upon the back and in blind fury
attack ourselves’ (189).
Whilst the remainder of this paper will certainly drawn upon this well known ‘role taking’
aspect of Mead's social psychology, we ground these insights in a less well known ‘version’ of
Mead that might be called ‘Mead‐the‐process‐thinker’ (see Cook, 1979; da Silva, 2008; Stenner,
2017). The process theoretical basis of Mead's thought is most fully expounded in his little
known work The philosophy of the present, published posthumously in 1932. The following
STENNER ET AL. 5

section will extract a number of analytically useful concepts from this work, including the
related notions of the ‘present’ as the ‘seat of reality’, the ‘emergent event’, the ‘revocable and
irrevocable past’, the ‘prevising’ of a future, and the ‘passion of self‐consciousness’.

1.2 | Theoretical orientation: A psychosocial process approach

Mead's process thought begins from the ontological position that the world in which we exist is
a world ultimately composed of events or what Whitehead calls actual occasions (Stenner, 2008).
With respect to psychology and the social sciences, it is the fate of human beings that our
realities are actual only in a present and that our pasts and our futures gain their actuality only
from our present moment: ‘reality exists in a present’ (Mead, 1980: 1). Since the past that has
passed has ceased to exist, we are obliged to reconstruct it in every present moment, and we
do so with an eye to a not yet existing future. And yet each present is an event that
becomes and then perishes, its disappearance conditioning and giving rise to the next present
occasion. The self‐identity of the present is in this way continually informed by the past it
constructs in the present. What we call ‘self’ or ‘self‐identity’ thus stretches back to the
past and forward to the future: but it hangs upon an always present occasion of actual
experience.
This theoretical stance frames our examination of how a diagnosis of ADHD informs
women's reconstructions of their pasts as they anticipate their futures. Rather than directly
engage with the controversies surrounding the ontological status of ADHD (Singh, 2008), we
observe that, as a social category, ADHD serves as a means or medium in the present to ‘make
sense’ out of what has disappeared into the past in order to project a more comprehensible and
manageable future. It serves, in short, as a resource for temporalising or for binding time.
Arguably, there is little to be gained by polarised debate between those who stress that ADHD
is a medical reality whose material truth must be insisted upon (Barkley, 1997; Hallowell &
Ratey, 1995), and those who consider it a social construction implicated in the management
of conduct deemed dysfunctional (Conrad, 2007; Fitzgerald, 2009; Timimi, 2005, 2007). The first
position places too much faith in the possibility of a secure grasp of a permanent reality
(the irrevocability of the past) and the second gives itself too fully to the idea of an infinitely
maleable past entirely subject to present social definition (the revocability of the past).
Mead (1980: 2) argues that the past is ‘both irrevocable and revocable’. The key to the
revocable nature of the past is the concept of the emergent: the emergent changes things. Mead
(1980: 23) defines the emergent event as:

the occurrence of something which is more than the processes that have led up to it
and which by its change, continuance or disappearance, adds to later passages a
content they would not otherwise have possessed.

The emergent is thus novelty: a new becoming that was not there in advance. New ideas, for
example, ‘emerge’ for a given individual, and new social practices (and identities) ‘emerge’
within a given community (Andreouli, Kaposi, & Stenner, 2019). The emergent always and only
arises within the present, but its appearance creates a new standpoint – a new present ‐ from
which the past is looked back upon, and reconstructed. This is why Mead refers to the present
as the ‘seat of reality’ (32). From the standpoint of the emergent, the past thus becomes a
different past (see Kosseleck, 2004). Put differently, in light of the emergent, what can now be
6 STENNER ET AL.

considered the ‘past past’ (7) becomes distinguishable from the ‘present past’ (i.e. the past
proper to the newly emergent present). In other words, a past now recognised to be outmoded
(the past past) is superseded by a past of a newly emergent present (the present past).
If the emergent is the key to the revocability of the past, then for Mead, this by no means
entails a denial of irrevocability: that the past is irrevocably gone and that it happened just as
it happened, and in no other way. It is the fate of every present to slide into the past and thus
to become a past present. What has passed cannot recur, although it always causally conditions
the arising of the present. The irrevocability of the past, as Mead (1980: 3) suggests, concerns the
fact that there is always and inevitably ‘a finality that goes with the passing of every event’. That
something was and is no longer, is irrevocable and never changes, but what does change is the
‘what it was’ (3). The ‘what it was’ is, however, revocable because it concerns the importance of
‘what it was’, and that importance belongs always (as a present past) to the present moment
from which the past is reconstructed. The emergent event changes the past because it
transforms that present importance.
In this way, much like other process thinkers such as Whitehead and Simmel (see Stenner,
2017, 265–274), Mead is able to reconcile the initial insight that ‘reality exists in a present’ (1)
with the equally important insight that there is no such thing as an ‘instant’ of present time
abstracted from its past and future: ‘If we introduce a fictitious instantaneousness into a passing
universe, things fall to pieces’ (177). There is, rather, ‘an unalterable temporal direction in what
is taking place’ (13) … and ‘in this passage what has occurred determines spatio‐temporally what
is passing into the future’ (13). What has taken place is part of a passage: it issues in what is
taking place. Again, this irrevocability of passage does not preclude the revocability of the past's
importance to a changed present. The reconstruction of the past is basic to the conduct of any
being that makes sense of events, the better to pre‐empt the future and hence operate more
effectively in the present.
For Mead, then, the emergent introduces a new present that, if it is to sustain itself into the
future, must reconstruct its past. This ‘if’ implies that an emergent present need not survive in a
form that allows it to transmit its inheritance to the future. In other words, what Greco and
Stenner (2017) call a pattern shift need not occur on the strength of an ‘emergent’ alone. If
the emergent is to be accepted as a new present, the past must be re‐written from the new stand-
point it opens up (Hacking, 1995). Once re‐written, the emergent ceases to be an unpredictable
novel event. With the benefit of hindsight, it ‘ceases to be an emergent and then follows from
the past which has replaced the former past’ (Mead, 1980: 11). The past thus ceases to appear
revocable, and relapses into the seeming irrevocability whereby what is now taking place
necessarily follows from what necessarily took place. Rather than appearing as a shocking
rupture, the emergent present, to use Mead's neologism, now has a past which issues into a
present which can ‘previse’ (12) a predictable future (i.e. to see or predict it in advance, or to
expect it). In the report below we attempt to clearly illustrate these abstract theoretical processes
using the accounts of our participants as they explain how their knowledge of ADHD affected
the temporality of their identity.

2 | METHOD

The project worked with a small strategically sampled group of participants. This obviously
limits the conclusions that can be drawn from the study, but our aim was not to generalise to
a broader population but to gain rich insight into a small number of cases. Following receipt
STENNER ET AL. 7

of full ethical clearance, participants were initially recruited through two routes: an online sup-
port group for people with ADHD, and two local community support groups. Women with a for-
mal diagnosis (whether in childhood or in adulthood), and also women who self‐diagnosed with
ADHD (without a formal diagnosis), were invited to participate in the study. This recruitment
strategy yielded 14 interviewees, but since none had been diagnosed during childhood, a further
round of recruitment was undertaken through a local university, yielding two more participants
who had received diagnoses as teenagers. Participants were given the choice to be interviewed
face to face in community centres, or if preferred, by telephone.
An interview guide was developed, informed by previous research, to explore key issues of
identity and transition for women with ADHD. Interviews began with the researcher expressing
an interest in the participant's life story with respect to ADHD, including how ADHD may have
impacted their life at different moments, and inviting them to talk about all aspects that they
consider relevant. They were told to expect that the researcher will keep interruptions and fur-
ther questions to a minimum and will be prepared to allow long pauses for reflection should
these occur. Nine of the 16 participants were self‐diagnosed at time of interview, and 5 of the
remaining 7 had received formal diagnoses of ADHD as adults.
The 16 interviews were transcribed verbatim and the content anonymized. The data corpus
was coded following an initial thematic analysis during which each audio recording was lis-
tened to by at least one analyst while reading the transcript to enhance accuracy. The data
was then subjected to a thematic decomposition by a second analyst (Stenner, 1992, 1993;
Ussher, 2003; Ussher & Mooney‐Somers, 2000). Unlike pure thematic analysis (and some forms
of grounded theory) which analyse a data corpus structurally into cross‐cutting content themes,
thematic decomposition does not pretend to a purely inductive and complete identification of
themes, but works dialogically between theory and data, often deploying positioning theory
(Davies & Harré, 1990) and other forms of process thought. In the analysis below we sought
to identify content that speaks to transformative events and reinterpretations of the past
(Stenner, Church, & Bhatti, 2012). The aim was to give a theoretically nuanced but data‐
grounded exegesis of the interview content through the identification of themes that indicate
dynamic constructions and reconstructions of reality. Thematic decomposition shares with dis-
course analysis (Potter & Wetherell, 1987) an attunement to the action orientation of discourse,
but without ‘bracketing out’ the experiential backdrop to the communication process.

3 | R E S U L T S OF TH E A N A L Y S I S

The analysis will focus on a sub‐set of participants whose accounts were particularly relevant to
the thesis of this paper. This is because they used remarkably similar terms to describe a key
moment of realisation that the category ADHD applies to them. This opens a space for putting
Mead's concept of the ‘emergent event’ to analytical use, along with the related concepts
described above. For these participants – whom we will call Ruth, Sarah, Jill and Maria ‐ this
moment of realisation was connected to discussions around the ADHD of their own child.
The formal diagnoses of three of these participants (Sarah, Jill and Maria) were prompted by
these experiences (Ruth is self‐diagnosed).
Before presenting the analysis, it is important to be clear that we are not claiming that this
kind of emergent experiential event prompted by their own children was a feature for all of the
women in our sample (several of whom did not have children). Some, for example, identified
with ADHD after seeking help in connection with other co‐morbid conditions. For example,
8 STENNER ET AL.

participant 6 – who sought help for an eating disorder and drug abuse ‐ describes ‘a slow
dawning realisation’ that the category ADHD applies to her, rather than a decisive event.
Participant 1 describes a phase of difficulty in college – attributed at first to dyslexia and
dyscalculia ‐ during which ‘alarm bells started ringing’ about ADHD. Others (five participants
in particular) recognised themselves via their child's diagnosis but did not describe this in
terms of a distinctive emergent event of realization. Finally, another participant does describe
an emergent event, but not one connected to children. She describes walking in circles
around a friend in a supermarket while being told she might have ADHD. She promptly
looked it up on the internet and describes a ‘wow!’ experience. Without denying these very
different experiences, the following analysis will focus on the accounts from Ruth, Sarah, Jill
and Maria.

3.1 | ADHD identity as product of an emergent event: A ‘lightbulb

moment’

In the accounts of this sub‐set, the moment of realisation is described as a life‐changing event.
For Sarah, Jill and Maria this emergent event triggered a prolonged quest for diagnosis. Maria,
for example, states that her daughter:

has a diagnosis of ADHD … . And that's where we realised that I had it … . My dad
was in total denial, absolutely idolises my daughter and vice versa and he was, “no,
there's nothing wrong with her”, but equally would keep saying, “why does she do
that, why does” ‐ and in the end I, I, I still hadn't clicked. I showed him the
symptoms and he looked at them and he just went, “that's you”, and we both went,
“oh my goodness, that's me!”

Maria describes her initial disagreement with her father over the ADHD status of her daugh-
ter. The doting grandfather cannot accept that there may be something ‘wrong’ with his grand-
daughter and yet is also sufficiently unsettled to keep asking questions. During a decisive
moment whilst considering typical ADHD symptoms, the father comes to newly recognise that
these symptoms apply to his daughter. This in turn allows Maria to view herself as a new object
from her father's perspective. Taking her father's perspective to herself, Maria describes how the
same shock of self‐recognition ‘clicked’ for her (“oh my goodness, that's me”). The sense of
surprise expresses the novelty of the self that is observable for the first time thanks to this
new perspective.
Jill uses the expression ‘lightbulb moment’ to describe her very similar story:

I think it had pretty much been two years to diagnosis from my first lightbulb moment
of, “oh, ADHD, hello” … ...and the prompt was entirely my son's behaviour and his
progress through the education system.

We must of course recognise that these metaphors of ‘clicking’ and ‘lightbulbs’ also serve a
rhetorical purpose of heightening the listener's interest in the account. The fact that these epi-
sodes may not have been as instantaneous as the opening of an electric circuit, however, should
not distract us from their subjective importance in the temporal unfolding of our participant's
experiences. This importance expresses their emergent quality as novel and unpredictable events
STENNER ET AL. 9

of insight, and it is this novelty – along with the associated illumination ‐ that is captured in the
lightbulb/clicking metaphors. The emergent event of novel self‐recognition is surprising
because, looking backwards, it introduces a new element that affords a reconstruction of a past
that now belongs to a present that has been superseded. We might say that a new present now
has the potential of superseding a past present. Also, looking forwards, the emergent event lends
the subsequent passage of events a new content and new possibilities. The emergent event, in
short, opens the possibility for a subjective pattern shift whereby a previous pattern of self‐
consciousness passes into another: after the event, things are different because the ‘self’ which
presides over temporal experience occupies a new present (see Greco & Stenner, 2017).
As noted in the introduction, such subjective pattern shifts do not follow an emergent event
automatically. Rather, if the novel perspective is to endure and be efficacious in the future, the
past must be meticulously reconstructed from the vantage point of its newly emergent present,
and this takes time and commitment. Participants described the emergent event ‐ the ‘click’ or
‘lightbulb’ moment ‐ being followed by a prolonged phase of actively seeking a diagnosis,
despite obstacles: ‘a very difficult two years’ (Maria). Note that, for these participants, diagnosis
did not prompt the pattern shift, but followed from it as a form of validation by way of formal
external recognition. Jill describes a ‘two‐year fight to, to get it recognised. … because it took an
awful lot of evidence to get it...’. Sarah offers a similar account:

‘the reason why I got diagnosed was because I have a 13‐year‐old son … diagnosed
with ADHD last June’ … once Jack was diagnosed I was very proactive at looking at
ADHD’.

In these cases, it is not the occurrence of a formal diagnosis that constitutes the emergent
event, but the emergent event of transformed recognition that sets in motion the process of
acquiring a diagnosis. The formal recognition bestowed by a diagnosis therefore supplements
a prior subjective transformation or pattern shift, and it is this that can be described as the
acquisition of an ‘ADHD identity’.

3.2 | Transformation of the meaning of the ‘object’ called ADHD

As described in the introduction, the category of ADHD as a ‘social object’ serves to reconstruct
a sector of experience and conduct relating to problems with attention as causally influenced by
a specific medical condition. The category thus gives a new salience to this sector of experience
and conduct, singling it out as a coherent figure for thought, communication and practical
attention. Since ADHD is a medical diagnosis, the category comes with a sense of scientific
‘factuality’, although in ordinary discourse and some media coverage it is also often treated as
controversial (Horton‐Salway, 2011, 2013). Like most adult members of society, these partici-
pants had encountered the category of ADHD prior to their pattern shift. The emergent event
of a ‘lightbulb’ experience, however, entails a new encounter with the ‘object’ ADHD, and thus
involves a decisive change in the meaning of this object: ADHD is resignified. Participants, for
example, describe having been familiar with the word ‘ADHD’ before the emergent event, but
having understood it in a trivial way, perhaps as a controversial media topic, or as the subject
of gossip amongst parents about ‘naughty boys’. Some, for example, described it as a ‘dirty word’
or a ‘stereotype’. The emergent event occasions the transformation of this trivial understanding
of the object into something that is experienced as far richer and deeper. After the event, in
10 STENNER ET AL.

other words, the participants are able to view the object ‘ADHD’ from two very different per-
spectives. On the one hand, they have the perspective of a world they occupied in the past (their
‘past present’ with its now ‘past past’), and, on the other, that of the world they now occupy (the
‘present present’ with its ‘present past’).
Before Ruth became aware of her own possible ADHD status through the diagnosis of her
son, she reports thinking that:

ADHD is somewhat of a dirty word still uhm so I think that was more ..it certainly
wasn't anything I overheard or … just in the media didn't really know anything
about it … … I knew the word ADHD existed but I didn't know anything until I
actually had my son uh …

In a comparable way, Jill states that after her son's diagnosis she: ‘actually stopped, um,
stereotyping ADHD as a thing and actually looked at what it involved’.
These extracts tell the story of a newly discovered sensitivity to the complexity of ADHD as
an object, and to the ever‐present possibility of stereotyped understandings. To analytically illus-
trate another of Mead's concepts, this new sensitivity is associated with a new importance which
is carried forward in the form of a strong critical appreciation of how ADHD can be poorly
understood to the detriment of those who are characterised by it. The interviews are saturated
with a sense of the participants having for too long misrecognised their own natures, having
been recurrently misrecognised by others in the past, and having to challenge the ever present
likelihood of misrecognition by others in the present and in the future. They have been
misrecognised as the ‘class joker’ (Ruth), as ‘a spoilt little bitch’ (Sarah, p.3), as ‘aggressive’,
‘rude’ and ‘moody’ (Jill) as an ‘absolute nightmare’ and ‘naughty’ (Maria), and so on, and it is
likely that these misrecognitions were, for each of these women, key ingredients in what Mead
called ‘the passion of self‐consciousness’. Fidelity to the emergent event means correcting these
problematic constructions by reconstructing the past from the vantage point of the new present
it brings into view. This task, or effort after reconstruction, in turn comes to occupy the imme-
diate future of our participants. Ruth, for example, describes herself as a ‘flagship’ whose mis-
sion is to enlighten people about the difference between the true nature of ADHD and the
stereotypical misunderstandings:

… we need to set the record straight here I'm a kind of flagship … because I'd like to
enlighten everybody I like to sort of enlighten everyone with my knowledge and
actually people don't always want it.

In becoming a flagship, Ruth, as it were, says ‘no’ to the future that would follow from her past
present, and she says ‘yes’ to a different possible future that would follow from the consolidation
of her emergent present (a ‘future future’). Through the emergent event, then, the category
ADHD acquires a new and intense personal meaning as these participants encounter a richer
reality to it and, at the same moment, begin to apply the category to themselves, their children,
and others around them (particularly other family members). The category of ADHD, once
reconstructed in a ‘lightbulb moment’, affords the emergence of a new ADHD identity,
displacing the old. The self‐consciousness underpinning this identity supplies the participants
with a new perspective on their lives and on the person they have always been. Achieving this
new vantage point is a decisive moment, but, as we have seen, it does not complete or exhaust
the process of pattern shift. Rather, it sets it in motion by creating a new present perspective
STENNER ET AL. 11

from which the meaning of events from the past, and of possibilities for the future, can be more
or less painstakingly reconstructed and re‐imagined. Sarah, for example, describes:

always thinking there was something wrong with me. I remember always kind of being
told that I was a drama queen, that I was a spoilt little bitch, that I was a fidget, that I
was nosy, that, you know, all of that kind of stuff, I, you know, so I kind of grew up
thinking that I was just a spoilt little cow who wanted, you know, wanted
everything. My brother and sister hated me.

An emergent ADHD identity enabled this participant to reconstruct such events and thus to
re‐evaluate the deeply sedimented sense that she had been ‘bad’ since childhood: ‘I used to
think that something very, very bad had happened to me and I'd blocked it out.... And the
ADHD kind of made me stop looking.’ What was her present past, in other words, has become
a past of the past (a past past). The intensity of this transformation ‐ and its implications for the
future ‐ is well described by Sarah:

I desperately wanted help and I think when I, when I went to the treatment centre on
my own accord, it was almost then that I thought, this is what I've been looking for my
whole, whole life, somebody to listen to me, to what I'm saying and not say, don't be so
stupid. And, and now I recognise, you know, like because I've done so much work on
myself and because I've learnt so much, I recognise that my dad has probably got
ADHD.

3.3 | Transformation of the subject: ADHD as pivotal to a new identity,

with a newly irrevocable past

The above analysis shows how an emergent event can be the occasion for the becoming of a
new ‘ADHD identity’ which, in the words of Maria, ‘really, really defines me’. This identity
provides a new present from which perspective Mead's revocable past can be reconstructed.
The following quotations illustrate quite how meaningful that new identity is for those who
acquire it:

… it's who you are it's who I am to every fibre of who I am (Ruth).

Um, however, since the, the diagnosis, oh, oh it's, I, I can only see my life now post‐
diagnosis and pre‐diagnosis, I am a different person (Maria).

I really, really love what ADHD brings for me, if that makes sense … It makes, um, I
think it makes me a really interesting person to be around … Whereas before I used to
see who I was as a flaw and everything like that. Now I almost feel like I'm lucky to
have what I have and to be who I am (Sarah).

Yeah, I like it. I'm proud of it and I'm actually now really, really bloody proud of
myself … because I've had so many people knock me and I've had so many people
put me down … I have also been immensely critical of myself. Yeah. (Jill).
12 STENNER ET AL.

… everything about me from my height to my looks everything is down to my ADHD I

believe everything that is who I am I think it's because I have a tendency to stand up
for what I think is right it's again back again to the very young, right and wrong, the
injustice of it all … (Ruth)

The sense of injustice invoked in the last extract (and of pride and love in the other) is
important (it expresses the importance that Mead presents as pivotal to the revocation of a past).
It expresses the fact that the emergent becoming we are describing is not merely a neutral, intel-
lectual, cognitive affair but a deeply felt and thoroughly evaluative struggle. In the next section
we explore the proposition that the emotional stakes involved in the new ADHD identity are
very high because, for each of our participants, the old (superseded) identity was a morally
troubled identity. It was an identity characterised by forms of conflict and guilt, criticism and
self‐criticism that characterise Mead's ‘passion of self‐consciousness’.

3.4 | The deeply troubled nature of the old identity: The passion of
self‐consciousness

Each of these participants describe very difficult childhoods marked by a sense of self‐hatred
and self‐destruction arising within difficult family relationships. Ruth, who was brought up
mostly by her grandparents, describes a long history of feeling resented by other family mem-
bers for her ‘loudness’ and for appearing out of place. She describes episodes of being bullied
and bullying at school (including physically attacking a teacher) and expresses a profound sense
of the injustice of her situation:

we were all sitting down waiting for stories and I'd got up and said to the child ‘can
you save my space?’ the child had then not saved the space and let someone else in
uhm I thought there was plenty of room we could all sit down I sat down again the
supply teacher had uhm said ‘no you're not sitting there’ ‘but I was sitting there
first’ again the injustice of it all uhm so basically I wouldn't move so she told the
whole class they could do whatever they wanted to me as long as they moved me off
the chair so thirty children or 29 trying to kick me hit me punch me in the class.

Sarah also describes a difficult childhood ‘I cried all the time, very lonely, very sad, being on
my own and almost the voice inside my head was my only friend’. The youngest of three children,
she describes feeling excluded from the close bond between her older brother and sister whose
agendas dominated her parents' concerns. She describes her relationship to her sister (who
‘completely preoccupied life at home’ after having a son aged 15) in quite moving terms:

I almost loved my sister so desperately and wanted her approval and wanted her to
like me, because she hated me, but at the same time I almost wanted to be better
than her in my parents' eyes … I wanted to be like her, but I also wanted to destroy
her and that went on for a long, long time.

She felt resented ‐ ‘always kind of being told that I was a drama queen, that I was a spoilt
little bitch, that I was a fidget, that I was nosy … my brother and sister hated me’ – and her
response was to try to ruin their relationship: ‘I would just sit outside her bedroom door just
STENNER ET AL. 13

kicking it constantly’. At school she ‘was bullied or became the bully’ and had begun smoking,
stealing, drinking and being sexually active by the time she was 10. As a teenager and young
adult she describes regularly drinking until she passed out, moving ‘in and out of relationships’
and engaging in a pattern of binge eating and self‐starvation.
Jill describes herself as having grown up with negative thinking ‘as a very small child in a very
odd household’ where she felt she could never meet the ‘expectations laid on me’ by her parents
and that she had ‘not ever really had parental approval’. She says that ‘as a small child actually felt
I was living in the wrong family’ and that ‘I didn't like being a child’. She describes arguments
with her mother over who is to blame for her character (which she describes as ‘wilful non‐
compliance or wilful neglect of myself’): ‘My mum's always saying, “oh you blame us for every-
thing, you know, you were wild … it's not our fault”’. She perceived that ‘there was like almost like
a malevolence within me … What I felt was that I was actually a bad person … I was not an ade-
quate human being’. At school, she describes herself as ‘wild’ and ‘like some wild animal had
turned up in class and they were like, what do we do with, with her’. As a young adult, she would
‘get drunk beyond belief … and I was promiscuous’, and she became a drug user, describing
herself as ‘a very addictive obsessive’. She tried to take her own life ‘seriously on two attempts’.
Maria says comparatively little about her own childhood, but describes depression as being a
‘mainstay of my life’ and she defines her life as a ‘never ending, um, failure’ and a struggle: ‘I
had one of the mums at school say to me, what do you do all day? And it was very easy, one
word answer, struggle’. As a young person, she ‘had, um, anorexia, um, and bulimia’ and she
‘was suicidal in the past’ and has a diagnosis of bi‐polar depression. Relationships have ‘never
lasted for very long’ and they've always gone wrong, um, and they, I, I've never been married’.

3.5 | Giving oneself some slack by letting oneself off the hook

The profound desire for transformation described above is easily understandable given the trou-
bled nature of these ‘old’ identities. Participants describe in vivid terms how the emergence of
their new ADHD identity served as the basis for a new present from which they could recon-
struct a more accepting identity that they could be more proud of and positive about. Maria,
for example, describes how she is now able to give herself ‘some slack’:

… I, I get confused and overwhelmed so easily. The difference now is I don't berate
myself as, as much, if, if at all I suppose. No, I suppose I still do, but nowhere near
as much … I give myself some slack. I understand that I have a disability, a huge
disability that's had this ‐because I have it quite severely I think.

Sarah uses the different but comparable phrase of letting herself ‘off the hook’ to express the
same relief from embattled self‐criticism. She extends this changed attitude to her son, who she
now supports rather than criticizes (she now fights ‘his corner’):

Um, it's answered a lot of questions. Um, it's kind of let, I let myself off the hook. I
forgive my ‐ I, I believe that Max was sent to me as a gift to teach me and I almost
feel that as I work through his problems with him and do the things that he needs,
I'm healing that little girl inside of me. So, when he comes home from school and
says that things happen with a teacher I believe him and I step up and speak to his
teacher about it and fight his corner, whereas I grew up in an environment was,
14 STENNER ET AL.

well, you shouldn't have done that. So, so I almost feel like, like as I fight his corner I
fight mine too.

The category of ADHD thus allowed her to entertain a more positive and tolerant relation-
ship towards her self and her child:

Um, it's hard in the sense of the guilt that I feel around my, my children and the
behaviours, my behaviours towards, towards my parenting skills and the things, but,
you know, I have to tell myself that I was sick and that I didn't know any different...

In explaining their situation, these participants are very aware of the potential accusation
that ADHD can be used as an ‘excuse for behaviour word’ (Ruth). From their perspective, how-
ever, they are not offering excuses for past conduct, but understanding it:

I'm not saying, “oh it was an excuse”. I know I did some really shit things! I behaved
really badly at the time … There's no beating around the bush. I've done the guilt, I've
done the shame … What I've said is, “you've had ADHD which is actually fairly
debilitating … and what you did is understandable … in those circumstances”. (Jill)

And I like my ‐ I'm going to get upset now ‐ I like myself, um, and it is the reason for
all of those things and that it's not an excuse … .. It's absolutely 100% the reason why I
struggled at all of those things and probably will forevermore and unfortunately you've
got this condition which affects memory, organisation, distractibility and then you've
got age and it's probably going to get worse! (Maria)

3.6 | With the benefit of hindsight: Lay psychological theories of self‐

formation

Through reconstructing their past experiences in the light of the perspective afforded by an
ADHD identity, these participants are able to newly understand, not just their past feelings
and conduct, but also other people's past reactions to that conduct, and their own past reactions
to those reactions. In this way, they are able to unpick the process of their own self‐formation,
and to grasp – or at least offer a theory about ‐ how their own and other people's past ignorance
of ADHD has contributed to the construction of their own self concept and conduct. To use
Mead's neologism, on the basis of a newly constructed past, they are able to previse the future.
Jill expresses this quite complex ‘lay’ social psychology in the following terms:

And obviously there's a knock on effect, there's cause and effect and one thing leads to
another and I can look back and say, well, if my parents had been a little different,
you know, well, if this had happened, well, if that had happened, but I don't regret it.

Participants thus do not offer simplistic causal stories about how their behaviour issues in a
linear fashion from a medical condition of ADHD. Rather, the very misunderstanding of ADHD
enters as an active ingredient into their psychosocial formation through a complex layering of
STENNER ET AL. 15

events upon events. For example, Jill observes that if her parents had known about ADHD when
she was a child, she may not have developed the ‘negativity loop’ of self‐criticism, ‘wilful non‐
compliance’ and self‐neglect. Sarah likewise observes that with earlier knowledge of ADHD,
she might have felt less isolated and needy and so might not have engaged in the misbehaviour
that provoked the punitive reactions from her parents that fed into the next phase of her miscon-
duct. In these lay theories, ADHD does not cause anything directly, but feeds into the way prac-
tical and emotional reality gets constructed both by and for the participant. Unsurprisingly, the
holistic and temporal complexity of these lay theories imply that it is not discrete facts that can
serve as evidence for the importance of ADHD, but the entire life of a person with ADHD:

Um, I have to be honest, that's not across the board with my family and I have, there's
a huge gap now between me and my sister, because she, she doesn't understand … at
the beginning she didn't even believe that I had either of these conditions and she was
sort of belittling me and at one stage my mum and dad went round with evidence and
I thought, but why are you doing that, why should you have to? My whole life is, is the
evidence … (Maria).

4 | DISC USS I ON

The analysis offered in this paper draws on the experiences of a small number of women who
identify with ADHD. These experiences were theorised with the help of a number of intercon-
nected analytical concepts drawn from Mead, including the emergent event, the irrevocable
past, the revocable past (where transformations of ‘importance’ allow a past past to be distin-
guished from a present past), the ‘prevised’ future, and the passion of self‐consciousness. With-
out wishing to universalise these theorised experiences, it seems clear that they are, when
sensitively analysed, very informative about one of the routes by which women in the UK are
coming to identify with, and seek out a diagnosis for ADHD during their adult years. It provides
some insight, for example, into what Williamson and Johnston (2015, p.23) describe as ‘higher
rates of treatment seeking for adult women compared to men’.
The analysis provides examples of how women can come to a new sense of themselves as
adults with ADHD via an encounter with the ADHD of their own children. It provides a
detailed picture of how an emergent event can participate in transforming a prior identity based
on a history of often very difficult experiences and life problems, and of the often meticulous
process of personal reconstruction this entails. We can, therefore, better understand the central-
ity the new identity has for these women, and the energy and commitment with which they can
take forward their message about ADHD. We can also understand how, once the new identity
has sedimented, the past informed by ADHD itself becomes an irrevocable past with a facticity
that can seem beyond question. These findings indicate the value of a methodological approach
informed by the process thinking of Mead and others, which draws attention to the often quite
subtle and complex ‘lay social psychology’ articulated by the participants themselves.
Our concerns with the temporal reconstruction of identity provide a potentially fruitful way
out from the impasse of an increasingly polarised debate in which ADHD is presented as either
a form of social control, a strategy for gaining welfare benefits or a means for drug companies to
amass further wealth, on the one hand, or on the other, as a medical condition whose biological
veracity must be insisted upon. It is quite possible that, in different circumstances, it is all of
16 STENNER ET AL.

these things, and yet it is also a way in which people can make sense of the complexity of their
difficult lives, the better to become more active in the present.
It is, however, important to re‐affirm that the reality expressed by the participants discussed
in this paper is not the only reality in our sample, let alone in the wider‐world. Our analysis in no
way denies that there are other routes through which women encounter and adopt an ADHD
identity, and future research should explore this variety. Indeed, we agree with Brown and
Reavey (2015: 211) when they insist upon the situational specificity of experiences of all kinds,
whilst also aiming to develop concepts which ‘are meant to make connections beyond particular
cases’. Concepts like the ‘revocable past’ are not meant as transcendent categories into which
data chunks can be coded, but as common notions which point to commonalities between cases
that, in themselves, are always radically specific. The concept of the ‘irrevocable past’ then serves
in a comparable way, but also as a corrective to any one‐sided tendency (encouraged by its part-
ner the ‘revocable past’) to stress contingency over irreversibility (or vice versa).
It is also important to affirm the partial and selective nature of our analysis. We have
worked, for the most part, with a small set of concepts from Mead's Philosophy of the present
and applied them to those aspects of our interview transcripts which afford illumination by
way of them. An extended and more substantial analysis might connect this to a variety of other
bodies of work with which our approach is in dialogue. For example, it would be useful to
attend to what Brown and Reavey (2015: 210) call the ‘setting specificity’ of participant's expe-
rience. For those women who encountered their own ADHD through that of their children,
for example, the school setting was decisively important, and schools as institutional spaces
clearly play a key role in patterning the experiences that unfolded (as do medical encounters
in GP waiting rooms, experiences in work places, and so on). More emphasis could also be
placed on gendered relations of power or on the institutional power of medicine (Hacking,
1995). Connections could also be made to what Brown and Reavey (2015: 107) refer to, not just
as experiencing ‘with, through and for others’ (as when Maria realises she might have ADHD
‘though’ her father's recollection of her as a child) but also as ‘managing the memories of others’
(as when Maria manages the ‘gap’ in understanding that exists between herself and her sister).
Inflected beyond memory, it would also be useful to further expand the connections to work
on ruptures and transitions more generally. From the perspective developed by Zittoun (2008),
for example, ‘emergent events’ followed by a transformed process of re‐signification and re‐
description might be described as ‘ruptures’ followed by ‘transitions’, where the latter includes
the use of ‘symbolic resources’ to re‐position and re‐locate the person in the symbolic and social
field of their life‐space. This in turn raises important questions of agency and affect, including
the extent to which the phases of transition which follow events that rupture biographical
trajectories are such that they increase or diminish the powers of the actors involved (Stenner,
McFarquhar, & Bowling, 2011), or perhaps hold them suspended in a ‘liminal hotspot’ (Greco &
Stenner, 2017).
Finally, we hope that our analysis provides a window into the growing tendency to reject
pathologizing aspects of diagnoses (where difference is equated with diminished value), and
to stress instead a discourse of difference grounded in equality (Silberman, 2015). Indeed devel-
opments in critical disability studies, particularly critical autism studies offer a way of enabling a
discourse of difference and equality (O'Dell, Brownlow, Bertisldotter Rosqvist, Orsini, & Ortega,
2016; Davidson & Orsini, 2013). The category of ADHD allowed our participants to reconstruct
what they previously thought of as highly negative aspects of their characters as forms of differ-
ence that have been subjected to systematic misunderstanding. This allows them to affirm the
value of their difference.
STENNER ET AL. 17

ORCID
Paul Stenner https://orcid.org/0000-0003-4505-6422

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How to cite this article: Stenner P, O'Dell L, Davies A. Adult women and ADHD: On
the temporal dimensions of ADHD identities. J Theory Soc Behav. 2019;1–19. https://doi.
org/10.1111/jtsb.12198