Boy, Interrupted
A neuropsychological evaluation confirms a well-masked lifelong disorder.
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PASSING OUT IN FRENCH
I was in a therapy session perhaps a year ago talking about difficulties I had in school when I first had validation that my consistently disastrous academic record wasn’t because I was naughty, lazy, ungrateful and irresponsible, a character breakdown that the adults in my family have embraced until this day.
They weren’t minor difficulties: powerless to make my parents understand that my struggles were real, I stopped attending class during the first trimester of the equivalent of eighth grade at the British school in Rome. I would get off the school bus and wander the fields all day, hanging out with seniors, whose schedules were more flexible. I was taken out of school and tutored for the remainder of that year in preparation for St. Stephen’s, the small American prep school across town, where it was felt I would do better. I didn’t.
“I remember in French class when I was eleven or twelve and I was asked to conjugate a basic verb like avoir or vouloir, and I couldn’t do it,” I told Dr. Borkheim, “The teacher yelled at me, and the room began spinning and I passed out momentarily from the stress.”
“Oh, so you had a learning disability,” he said matter-of-factly, as if it were clear to him from a single anecdote that what I’ve long suspected to be the real issue behind my failures at school was true.
I’ve tried to tell my parents at various times throughout adulthood that I had a learning disability — “maybe dyslexia?” — halfhearted attempts at an alternative explanation for my colossal failures at school than what was already set in stone in the family histories. They’ve been brushed off with a slight smile and no response, the subject changed in that Anglo way that Emerald Fennell captured so perfectly in the dinner-table scenes in Saltburn.
As my suspicions were summarily tossed onto the Whatever Heap of Grievances about their shortcomings as parents I was still stuck in deep into middle age, I dutifully resumed wearing the family’s character breakdown that I also believed almost absolutely: that I was simply naughty, lazy, ungrateful, irresponsible and prone to fits of rage called “The Wrath of James.” I deserved everything that happened to me and then some. They’d sacrificed everything and supported me “far more than any other parent has.”
Dr. Borkheim’s words resonated over the upcoming months until it became a topic that I brought up with enough frequency in our weekly sessions that he finally said, “Have you ever had a neuropsychological evaluation?”
“A what?”
While he eschews DSM diagnostic terms in his treatment — “Psychology isn’t a real science; it’s a collection of opinions” — Dr. Borkheim nonetheless conducts official diagnoses for the State of California using neuropsych evals, as psychological jargon calls them.
“Can it determine a learning disability from so long ago?” As an almost pure autodidact who teaches himself through experience, my mind has become another planet over the decades. I’d go so far as to say that if the curriculum contained no mandatory classes in subjects that didn’t relate to a range of interests that have expanded considerably since I dropped out of Wesleyan after my freshman year, at this stage of my self-teaching I could easily get a B.A., perhaps even a Ph.D.
“Absolutely,” he replied.
The test took place over four hours on the Saturday before Christmas. In the initial part, I vaguely recognized certain puzzle-solving elements using blocks from tests that were administered by child psychologists on two occasions: once when I was around four in New York, another when I was six or seven by an American psychologist in Rome.
Midway through the test, Dr. Borkheim’s demeanor became detached, perfunctory and firm, assuming the role of a teacher administering an exam under the clock in school. Sense memory kicked in and urged me to panic. You are failing.
I recognized it for what it was, a deliberate recreation of the experience of being in school. I closed my eyes for a few moments and reflexively allowed zekr meditation to flood my mind with calm.
This is what it was, exactly this. Do your best. Allow yourself to fail.
I could tell that Dr. Borkheim was surprised by what he was tallying, maybe shocked. Zekr kept me neutral from guessing what he might be seeing.
When he pulled out Rorschach Test cards for the final part of the eval, I snapped out of calming mode and perked up. This would be fun.
“I didn’t know this was on my bucket list, but I guess it was,” I said before greedily plunging into so many interpretations of the ten inkblots that Dr. Borkheim had to stop me now and then; some must’ve been original because he asked me to show him exactly where in the splotches I saw a samurai playing a Go master before battle as a test of his tactical preparedness, much like the dynamic he and I were now engaged in.
After the test, Dr. Borkheim relaxed in his chair and said, “Well, your IQ is on the higher side of average.” That must’ve been what was shocking. “And you have ADHD, which is why you did so poorly in school. Had you been given Adderall, you probably would’ve done well. If you’d taken Adderall before this test, your IQ results would probably be off the charts.”
“But I am on Adderall.”
“WHAT?!”
That meant I would’ve scored even lower on the IQ test. He didn’t need to quantify it; I knew the ADHD was severe.
I’ve never cared about IQ tests, of measuring my intelligence against others. I assumed I was above average because I’ve been told that since I can remember. The single most-used adjective people use about me is “brilliant.”
The other issue is I find the idea of a standardized measurement of intelligence problematic. Well before battles over race differences erupted on internet forums I suspected that the IQ test was calibrated to measure a specific kind of intelligence most common among Europeans and Asians. I remember first hearing about Mensa and finding it creepy.
I’ve always firmly believed in the Theory of Multiple Intelligences — how else could I explain myself?
“As I’ve mentioned before, I have problems with the entire education system,” I said. “It’s this rickety, patched-up Victorian thing lumbering across children like Howl’s Moving Castle and making their lives miserable. But I recognize that standardized tests like the IQ and SATs are useful for the vast majority who constitute a norm.”
Dr. Borkheim speculated that it was my abnormal linguistic intelligence that fooled everyone into thinking that the only thing wrong with me was a bad character; after all, it had fooled him for seven years.
As I was leaving I said, “You also didn’t test for creative intelligence.” He nodded firmly in agreement. But can that be measured?
THE FOG
As I cycled home, the effects of what was a major breakthrough in my therapy began to seep in. After seven years of breakthroughs both major and mildly illuminating, I knew them for what they were and allowed them to happen.
At home, I sat at my desk, and a blinding cascade of tears fell, through which rapid-fire memories rushed at me like the opening credits of a Marvel superhero movie, these angry, vengeful, powerful icons of ruthless Americanness rushing at me, stumbling in confusion as my perspective on them changed.
I was punished relentlessly for failing at school; the abuse and terror were constant throughout my childhood. But I’d been gaslighted into believing it was all my fault, something I deserved from parents I’d driven beyond breaking point with my naughtiness, laziness, ingratitude, irresponsibility and outbursts of rage.
Given the new reality that was forming, I hadn’t been wrathful enough.
My family are formidable people: good-looking, sophisticated, upper-crusty, wealthy, charming — arguably the most believable kind of people there are. Up until 2016, when I went into therapy with Dr. Borkheim and began to undo the damage, I believed their caricature of me without question, for the most part. I accepted my ongoing exiles and punishments and kept coming back for more. I just thought it was overly harsh and unfair, and the abuse was unacceptable, no matter what a little monster I might’ve been.
“This has been going on in your family since 300 B.C.,” Dr. Borkheim said. “You’re going to have to accept that they are never going to change, and will not see things your way. Can you do that?
Probably not, I thought. The injustice was too overwhelming for forgiveness, much less acceptance. But over time I got to a reasonable place with it. In 2019, unable to live in the dynamic any longer, I became estranged from the adults in my family. I only communicated with my sister’s daughters, Savannah and Uma.
With this new information, confirmed and sealed by a reliable scientific methodology used the world over, my reality about them, what happened, but most importantly my self-image was fracking and reforming, nearly overwhelming.
When a perceived reality lives beside an objective reality, constantly clashing with it, and the perceived reality continues to try to dominate it creates cognitive dissonance; for example, “I know smoking is bad for me, but I’ve read plenty of online forums that say the damage depends on the person, plus I’m anxious and it’s better than benzos for calming anxiety, so it’s okay for me to carry on smoking.”
As long as the doubt lingered that I was all those terrible things — for the sake of the next generation, I’m now also a liar who makes up stories about his childhood abuse to malign his wonderful, loving, supportive family — I was trapped in a sort of involuntary cognitive dissonance. The diagnosis of severe ADHD brought that all to a crashing close.
All was clear now. This knowledge and certainty most priceless Christmas gift I’ve ever received. I was no longer to blame, for any of it. I’ve always had a disorder. My struggles throughout life from school to my chronic romantic failures to my stop-and-start career originate from it. No more punishments, banishments, public humiliations and tough-love hardships. I’m free from that mind trap, out of the toxic dynamic as my family’s scapegoated child, and increasingly elated bout it.
Hold up, I hear you say. If you were on Adderall during the test, you must’ve known that you had ADHD.
A little bit yes, but mostly no. As with so much in my unusual life, I fell into it by accident.
I was in Delhi working as creative director on the marketing for a sizable tech company, working on many creative deliverables at once in an attempt to turn the brand around and diversify it quickly. That sort of high-octane creative octopus is where I thrive, but it can also overwhelm me
My sister gave me some of her Adderall, not to keep going long hours and staying focused, more as a sort of cultural grafting from the Indian side of the family, “Here, try these pills, they’re excellent for XYZ…” As a fashion designer who stayed at the family’s house in Srinagar noted, “Your family are pill poppers.”
When I assisted photographer Pamela Hanson as a teen in Paris, the octopus performed beautifully for the first few months. As I lost interest in photography and the routine of lugging camera equipment as I chased Pamela into heavy traffic while she chased the most beautiful girls in the world, I became increasingly spaced out. Pamela started calling me, “Fog.” After I forgot the film in the hotel on a location shoot in Africa, she fired me.
The Fog has gotten me fired from every job I’ve ever had that wasn’t related to creative pursuits that I found engaging. I can fake it for a few months, but eventually the Fog will always win.
Taking Adderall was like waking up fully for the first time in my life. I asked my sister for more.
“But why?” she said. “You don’t have ADHD. Just the opposite.” Another of my character traits that’s more her personal peeve than anyone else’s is I’m “a control freak.”
When I got back to Los Angeles from India, I found a psychiatrist through my insurance — Dr. Borkheim is a psychologist who doesn’t prescribe meds and doesn’t approve of them for the most part. I went through the six-month process of trying various drugs until I reached the last possibility, Adderall.
As a final formality, I was given a self-assessment form with ten questions of the “On a scale of one to five, how would you rate yourself” kind. As I ticked off “Strongly agree” next to each of the symptoms, I thought, Wow, maybe I do have it after all. I was particularly struck by, “I talk over people.” From then on, with the help of Adderall, I’ve been mindful of stopping myself from doing that.
In other words, it was a self-diagnosis for the sole purpose of obtaining a medication I stumbled upon that benefitted me enormously.
After the neuropsych eval I read up on ADHD. What I’d always thought of as a bit of a joke as a disorder — it was treated as the butt of jokes when it first entered the mainstream in the 80s, along with bulimia — could be a serious condition, in a sort of yin-yang relationship with autism.
I was now neurodivergent, not a jumble of character flaws — my brain is wired differently. My Anglo-Celtic “gift of the gab” combined with my parents’ ultra-articulate banter kept my different brain camouflaged as a sort of glamorous insouciance and “an uncompromising approach to your work,” meaning I suck at anything I’m not naturally good at, and if you make me do anything that isn’t within reaching of my high-octane creative octopus, not even Adderall will stop the Fog from overwhelming me.
I slept for twelve hours the night after the eval. From the hypnotherapy work that I’ve been doing with Dr. Borkheim, I knew what was happening: my brain’s neural pathways were resetting to a new reality, which is what a breakthrough essentially is. I’d been through a few, but this was the mother of them all, quite literally, the origin of everything.
Over the following week, I slept a lot, often waking up muttering, “I’m neurodivergent.” The evidence was irrefutable: I was no longer to blame for any of what I am still blamed for over half a century later. It was exciting, and such a relief, but the size of the reality shift “did my head in,” as the British say. I read online that it’s called “a therapy breakthrough hangover” — that’s exactly what a realignment of that scale feels like.
I grappled with how to write what you’re reading right now. The first step, as with many pieces that can become overly complicated and tangential if I’m not careful, was to create the lead illustration, Self-portrait as an Inkblot. Connecting an important narrative visually sometimes helps me tell it verbally.
Then another thought crept in: What do I do now about the family and my estrangement? If they didn’t know about the extent of my disorder, either, shouldn’t they at least have the information and the opportunity to reset their own neural pathways?
As tempted as I am to continue unpacking this exciting development in my life, I’ll leave off here and resume with a Part Two of this essay next week, in which I’ll go back over my past fascination with mental illness, the longstanding conviction that I had a disorder, and explain precisely how Dr. Borkheim is successfully helping me rewire my brain through hypnotherapy to undo the decades of damage from abuse.
Thank you for reading.
PART TWO: ‘Boy, Reconstructed.’
AND I REPEAT:
Quibblers & Scribblers is a reader-supported publication with an affiliated concept shop featuring my designs. Free subscribers get 10% off and free shipping of infinite items in a single order. Paid subscribers get 20% off and free shipping on infinite items in an infinite amount of orders. Bargain, eh?
Now that my options for income from gainful employment are more diminished than ever, I’m reliant on my creative octopus more than ever. Please consider supporting my work by buying a piece of me at the Q&S Shop. Thanks!
And I love your inkblot!
James, you are both an incredibly astute, adult writer, and also the most heartfelt and beautiful innocent. I love how you are rediscovering yourself, allowing change into your belief system. For myself, I have found this to be the nectar that sweetens my life. Allowing change.
Blessings and hugs forever.