Stolen focus: why you can’t pay attention

Emma McKenzie-Edwards is an Oxford GP and Medical Educator. She teaches medical students at the University of Oxford.

Struggling to focus? Mystified that you’re struggling to read more than half a page in a book before losing your thread? Scrolling mindlessly through social media for hours? You are not alone.

In his new book, Johann Hari, mindful of his own and his family’s inability to be fully present, addicted to technology and exhausted (and hating it) starts to explore the reasons why we have are all struggling to focus.

He challenges the reader (page 9), ‘If I put you in charge of the world and you wanted to ruin peoples attention, what would you do?’  Many things probably leap to mind in general practice. Interrupt them all the time make them switch from task to task every few minutes. Overwork them and stress them out, so they are exhausted and can’t make decisions. Make them respond to correspondence and work related issues twenty four hours a day on a handheld device. This sounds cruel and malign, except that all of it is already happening.

He challenges the reader, ‘If I put you in charge of the world and you wanted to ruin peoples attention, what would you do?’

Since the smartphone phenomenon took off in the ‘noughties’, there has been an explosion of easily accessible and usable personal technology. A result of communications technology is that we can become available and accessible 24 hours a day. For most the separation between work and home life became blurred, and then seemed to disappear altogether. The culture shift, described by Hari, makes it hard to ignore your phone – those selling the hardware and software play on the way our brains work to manipulate behaviour and keep us looking. We work harder and longer than ever before. Tech geniuses (Hari cautions us) often ban their own children from using the gadgets, that they design. They send them to tech-free Montessori schools.

After a long awaited visit to Graceland with a relative where most people spent their time staring at iPads rather than looking around the mansion, Hari was inspired to address his stolen focus. He initially attempted a full digital detox in Provincetown for three months. This highlighted for him the importance of time to process information and time to allow your mind to wander or daydream. After a few weeks of relaxing and enjoying his tech-free time, he developed irritability and felt there was a void he needed to fill. He started to explore Mihaly Csikszentmihali’s work on the flow state. Csikszentmihali describes this as the process of doing something such that time falls away and you are ‘carried by the flow’. Children naturally fall into flow when they play, especially if it’s a new game. It became clear that pursuing a meaningful goal. Ideally, with some effort was important to fill the void. This is in stark contrast to the B.F. Skinner version of training living creatures to arbitrarily crave reward which dominates the tech of today. Work on flow state suggests that screen use offers the lowest amount of flow. Hari summarises (page 55) “To have a good life, it is not enough to remove what is wrong with it… We need a positive goal, otherwise why keep going.”

Feeling he’d made a good start, Hari started to dig deeper in to the issues and found that this issue had many more layers of complexity. Many other things are affecting our ability to act on what we know we should do to improve our attention. Lack of sleep, stress and exhaustion are a big factor. Some of the sleep studies in Boston in the 1980s found that staying awake for 19 hours resulted in  cognitive impairment equivalent to being drunk, “The less you sleep, the more, your world blurs in every way in your immediate focus, in your ability to think deeply and make connections, and in your memory” (gage 66). Doesn’t it make sense now to limit the those on-call shift hours?

The collapse of sustained reading is another issue. Reading in a sustained linear form -such as with a book, allows a deeper immersion in the story, as opposed to the screen reading which is often referred to as scan and skim reading. People understand and remember less of what they absorb on screens (termed ‘Screen inferiority).

Deteriorating diets and pollution are discussed in the book. Ultra-processed foods are so far from what was intended as human fuel, Hari argues, that we may as well be putting shampoo into a car engine (page 192). Our processed diet sends us on a daily rollercoaster of spiking and crashing blood sugar, which is exacerbated by caffeine. He cites studies suggesting that your brain functions up to 50% better if you eat a whole food diet that eliminates preservatives, additives, and synthetic dyes. Pollution and smoking also significantly the risk of developing ADHD and later dementia. ADHD diagnoses in Britain have soared. For every child diagnosed in 1986 there are now 100 children in this position. Between 1998, and 2004 the number of children being given stimulants doubles. Studies now indicate that less than 20 to 30% of ADHD diagnoses are likely to be due to factors that are biological or genetic.

Ultra-processed foods are so far from what was intended as human fuel, Hari argues, that we may as well be putting shampoo into a car engine…

Environment plays an enormous role in attention and it is this environment that needs to be addressed if we are to deal with the attention crisis that we are facing. Children need to play to develop social bonds, creativity and imagination and learn how to experience joy and pleasure. Plays build the foundation of a solid personality. We don’t allow our children to play freely anymore. Exaggerated fears of children being hurt or abducted, causes us to imprison them in their homes. As Hari puts it, “Children have needs, and it’s our job as adults to create an environment that meets those needs.” Throughout the book, Hari says he had to hold clearly in mind the structural nature of our attention crisis and found this a real struggle. He notes ‘We live in and extremely individualistic culture, where we are constantly pushed to see our problems as individual failings, and seek out individual solutions.’

You’re unable to focus? Overweight? Poor? Depressed? We are taught in this culture to think: ‘That’s my fault. I should have found a personal way to lift myself up and out of these environmental problems’ (page 202). We use drugs to put us to sleep and caffeine to wake us up. We juggle work and home life frantically and multitasking is the new normal. It’s clear that to recover a stolen focus it’s going to take a lot more than individuals working out their own personal answer. What can we do? Ban surveillance capitalism? Redesign social media sites to encourage focus? How about enabling human interaction rather than grabbing attention? Hari concludes he believes that now we must focus together or face the fires alone (page 277).

Featured Book: Johann Hari, Stolen focus: why you can’t pay attention, Bloomsbury Publishing, Hardback (PB/Kindle/Audible also available), ISBN 9781526620224, £20

Deputy Editor’s note: see also Review by Bransby T, Books: Lost Connections: Uncovering the Real Causes of Depression — and the Unexpected Solutions Searching for Depression Treatments.  

Featured Photo: White and green background, Andrew Papanikitas, 2023

The British Journal of General Practice and BJGP Open are bringing research to clinical practice. BJGP Life is where we add the debate and opinion to help ensure everyone benefits from that research.

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