Functional Symptoms: What It Is and Recognizing the "Default" System

To understand the symptoms, the doctor first draws a key distinction: a person has a "default system" — a background, not-quite-awake state — and full engagement with life, when the person has woken up, switched on, and motor function works at a hundred percent. Without this distinction, he says, "otherwise you simply can't understand it."

The "Default" System and Incomplete Switching On

The easiest way to grasp this system is through sleep. When we sleep and dream, motor function shuts off: in a dream we run somewhere, but the body doesn't run. The reverse also happens — paralysis on waking: consciousness has switched on, but motor function hasn't yet. The same background state "dictates" to a person during the day: he is still "not fully awake," and so he cannot hold attention on one thing.

Restlessness and Inability to Sit Still

The person gets distracted: a pencil drops — he is already looking there. He can concentrate only once he has fully switched on and engaged with life. Holding attention by effort causes a child great discomfort. This is genetically determined, so it is important not to scold — it is "pure neurochemistry."

Forgetfulness, Organization, and Planning

The main problem is with short-term memory. A person reads something and forgets it five minutes later, yet can recall events from a year ago in fine detail. Short-term memory switches on only with "waking into life." If it has "crashed," executive function suffers: mental arithmetic, organization, planning — because information must first enter short-term memory, where it is sorted, compared, and assembled into logic. That is why lectures, reproaches, and teaching don't work here — you are "just tormenting the person."

Impulsivity and Difficulty Waiting Their Turn

An impulse arrives — and the background system reacts instantly; the child cannot delay it. The doctor notes a pattern: the greater the time between stimulus and response, the more intelligent the person. When a child is asked something and asked again five minutes later, he no longer remembers: the executive function of thinking hasn't switched on yet.