Technopoiesis and the Evolution of ADHD: Diagnoses, Devices, and the Dynamic Fabric of Cultural Change
In the contemporary discourse around Attention Deficit Hyperactivity Disorder (ADHD), we witness a microcosm of a much broader and deeper phenomenon: the recursive entanglement of cultural narratives, technological tools, biological facts, and institutional infrastructures. What unfolds is not merely a shift in medical opinion or educational policy, but an instance of what we may call technopoiesis — the process through which new realities emerge from the recursive co-construction of knowledge, bodies, artifacts, and social systems.
This technopoietic lens allows us to reposition the evolving story of ADHD away from narrow binaries (e.g., real vs. invented, biological vs. cultural) and instead situate it within an epistemic-technological system that is irreducibly complex, deeply historicized, and continually in flux.
Diagnoses as Devices: The Looping Effects of Human Kinds
Philosopher of science Ian Hacking (1995, 2007) introduced the idea of looping effects, wherein categories of people, once labeled and institutionalized (e.g., "ADHD children"), begin to behave in ways that confirm, subvert, or reconstitute the category itself. Diagnosis becomes a technology of classification, simultaneously reflecting and transforming social life. The DSM itself is not just a book of symptoms but a stabilizing device within a biomedical platform (Clarke et al., 2003) that includes schools, insurance companies, pharmaceutical firms, and parents.
This is not merely the medicalization of behavior (Conrad, 2007); it is the technopoietic production of new norms, new forms of agency, and new configurations of life.
Cultural Evolution as Material and Recursive
We often conceptualize cultural evolution as running parallel to biological evolution, perhaps even in a separate dimension. But as thinkers like Georges Canguilhem (1991), Nikolas Rose (2007), and more recently Annemarie Mol (2002) have shown, the boundaries between biology, culture, and technique are porous and actively negotiated. The story of ADHD demonstrates that cultural evolution is not apart from biological evolution but emerges within and through it, carried forward by practices, technologies, and shared imaginaries.
Stimulant medications like Adderall are not just passive interventions acting upon a pre-existing biological substrate. Rather, they are actants (Latour, 2005) in a distributed network that reconfigures children's routines, teachers' expectations, and parents' hopes. The human organism, the social institution, and the pharmacological agent co-evolve.
ADHD as a Dispositif
Michel Foucault's notion of the dispositif (1977) is indispensable here. A dispositif is an assemblage of discourses, institutions, laws, administrative measures, and scientific statements that respond to an urgent need. ADHD emerged as such a dispositif during a time of expanding educational standardization, growing concern over student productivity, and the pharmacological turn in psychiatry. It is not an error or distortion within the system; it is the system adapting, mutating, producing new subjectivities.
Technopoiesis: Making the New Real
In this view, technopoiesis refers to the creative but constrained process through which new forms of life are generated via the intersection of technique (techne) and becoming (poiesis). Theories, diagnostics, and treatments are not neutral. They are generative infrastructures (Helmreich, 2009), shaping what is thinkable, feelable, doable. ADHD did not merely become more visible in the late 20th century; it became possible — as a lived identity, as a trajectory, as a pharmacological and educational niche.
This is where the concept of epistemic cultures (Knorr Cetina, 1999) becomes relevant. The knowledge practices of psychiatry, neuroscience, education, and pharmacology are distinct, but in the case of ADHD, they converge in a hybrid formation. Add to this biocapital (Sunder Rajan, 2006) and we have an economic structure that both drives and is shaped by the technopoietic process.
Feedback, Reflexivity, and Complex Systems
In cybernetic terms (Bateson, 1972; von Foerster, 2003), the ADHD dispositif exhibits second-order feedback. Theories (e.g., executive function deficit), treatments (e.g., stimulants), and measurements (e.g., behavior checklists) become recursive operators in the system: they act on people who are also interpreting and reacting to those very classifications. The diagnostic category acts as both observation and intervention.
Cultural feedback loops of this sort can produce both positive and negative outcomes. For instance, awareness campaigns might reduce stigma but also increase overdiagnosis. The publicization of suicide has been shown to correlate with increased suicide rates (Phillips, 1974), a phenomenon akin to what we might call mimetic contagion (Girard, 1977). In both cases, the system amplifies itself through recursive modeling.
From ADHD to an Ecology of Practices
Paul Tough's (2025) recent journalism traces the changing landscape of ADHD through a lens that is already attuned to technopoiesis. He identifies the shifting effectiveness of medication, the role of classroom structure, and the lived variability of symptoms. What he implicitly charts is the ecology of practices (Stengers, 2005) that give rise to the diagnosis and its management. These include teacher expectations, insurance codes, social norms around productivity, and neurobiological research agendas.
We can thus understand ADHD not as a discrete medical entity but as a distributed system of enactment. The condition becomes real through its recursive relations with institutional routines, technical artifacts, linguistic frames, and economic incentives.
Technodiversity and the Plurality of Worlds
The evolving discourse around ADHD also offers a compelling case study in technodiversity, a term emphasized by Yuk Hui (2016) to describe the multiplicity of ways that societies can relate to technology based on distinct cosmologies, histories, and epistemic commitments. Technodiversity resists the idea of a singular, universal path of technological development, highlighting instead the potential for alternative ways of integrating tools, knowledge, and values.
As Tough reports, ADHD is not experienced or interpreted in a uniform manner. There is significant variation in skepticism toward the diagnosis, in how people react to being labeled, and in the interventions they pursue. Some families embrace neurodiversity paradigms, while others pursue strict behavioral regimens or pharmacological solutions. In some communities, stimulant medications are seen as liberation; in others, as coercion. These are not merely individual preferences—they are situated responses shaped by cultural frameworks, economic pressures, and moral understandings of childhood, discipline, and difference.
This pluralism points to a landscape of technodiversity in action. The ADHD dispositif mutates as it travels across contexts. It is translated and reinterpreted through religious beliefs, parental values, institutional constraints, and local knowledge systems. This multiplicity can foster innovation and care—but it also sets the stage for ontological conflict, as different technopolitical imaginaries collide.
Thus, ADHD becomes not only a site of medical negotiation but a terrain of cultural struggle, where competing versions of the good life and human flourishing are at stake. As such, technodiversity is not only descriptive but strategic: it demands a pluralistic ethics attentive to local needs and resistant to epistemic imperialism.
Toward an Ethico-Technological Orientation
The challenge, then, is not to declare ADHD real or unreal, or to adjudicate its essence. Rather, we must ask: what worlds are being made through the dispositif of ADHD? Who benefits, who suffers, and what alternative futures might we imagine?
Technopoiesis invites us to hold these questions in creative tension. It encourages a shift away from essentialist diagnoses and toward an ontopolitics (Mol, 1999; Law, 2004) of care, specificity, and situatedness.
To see ADHD as a technopoietic formation is not to relativize it into oblivion but to recognize the profound interdependence of bodies, knowledges, artifacts, and institutions. It is to trace the genealogy of a cultural form in the making — and to ask how we might remake it otherwise.
Cited Authors and Works
Bateson, Gregory (1972). Steps to an Ecology of Mind.
Canguilhem, Georges (1991). The Normal and the Pathological.
Clarke, Adele E., et al. (2003). “Biomedicalization: Technoscientific Transformations of Health, Illness, and U.S. Biomedicine.” American Sociological Review, 68(2), 161–194.
Conrad, Peter (2007). The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders.
Foucault, Michel (1977). Discipline and Punish: The Birth of the Prison.
Girard, René (1977). Violence and the Sacred.
Hacking, Ian (1995). “The Looping Effects of Human Kinds.” In Causal Cognition.
Hacking, Ian (2007). Kinds of People: Moving Targets.
Helmreich, Stefan (2009). Alien Ocean: Anthropological Voyages in Microbial Seas.
Hui, Yuk (2016). The Question Concerning Technology in China: An Essay in Cosmotechnics.
Knorr Cetina, Karin (1999). Epistemic Cultures: How the Sciences Make Knowledge.
Latour, Bruno (2005). Reassembling the Social: An Introduction to Actor-Network-Theory.
Law, John (2004). After Method: Mess in Social Science Research.
Mol, Annemarie (1999). “Ontological Politics: A Word and Some Questions.” The Sociological Review, 47(S1), 74–89.
Mol, Annemarie (2002). The Body Multiple: Ontology in Medical Practice.
Larroche, Valarie (2019). The Dispositif: A Concept for Information and Communication Sciences
Phillips, David P. (1974). “The Influence of Suggestion on Suicide: Substantive and Theoretical Implications of the Werther Effect.” American Sociological Review, 39(3), 340–354.
Rose, Nikolas (2007). The Politics of Life Itself: Biomedicine, Power, and Subjectivity in the Twenty-First Century.
Stengers, Isabelle (2005). “The Cosmopolitical Proposal.” In Making Things Public: Atmospheres of Democracy, edited by Bruno Latour and Peter Weibel.
Sunder Rajan, Kaushik (2006). Biocapital: The Constitution of Postgenomic Life.
Tough, Paul (2025). “5 Takeaways from New Research About A.D.H.D.” New York Times Magazine.
von Foerster, Heinz (2003). Understanding Understanding: Essays on Cybernetics and Cognition.
