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Life & Times

Books: Stolen Focus: Why You Can’t Pay Attention

Doomed to Scroll

Emma McKenzie-Edwards
British Journal of General Practice 2023; 73 (734): 417-418. DOI: https://doi.org/10.3399/bjgp23X734877
Emma McKenzie-Edwards
Emma is an Oxford GP and Medical Educator. She teaches medical students at the University of Oxford. Email:
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Johann Hari Bloomsbury, 2023, PB, 352pp, £7.99, 978-9781526620217
Figure

Struggling to focus? Mystified that you’re only managing 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 are all struggling to focus.

He challenges the reader (p.9), ‘If I put you in charge of the world, and you wanted to ruin people’s ability to pay attention, what would you do?’

Many things probably leap to mind in general practice. Interrupt them constantly and make them switch from task to task every few minutes. Overwork them and stress them out so they are exhausted and unable to make decisions. Make them respond to correspondence and work- related issues 24 hours a day on a handheld device. This sounds cruel and malign, except that all of it is already happening.

TECH MANIPULATION

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 many, 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 in order to manipulate our 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 felt inspired to address his stolen focus. Initially he attempted a full digital detox in Provincetown, Massachusetts for 3 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 Csikszentmihalyi’s work on the flow state. Csikszentmihalyi, a former Hungarian-US psychologist, described this as the process of doing something such that time falls away and you are ‘carried by the flow’.

For children, it is natural to fall into a state of ‘flow’ when they play, especially if it’s a new game. It became clear to Hari that pursuing a meaningful goal ideally, with some effort involved, was important to fill the void. This is in stark contrast to the BF Skinner version of training living creatures to arbitrarily crave reward (essentially a dopamine boost not dissimilar to Pavlovian conditioning), which is the model dominating today’s tech. Work on flow state suggests that screen use offers the lowest amount of flow. To summarise, Hari says ‘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?’ (p.55)

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 be doing 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’ (p.66). Doesn’t it make sense now to limit 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 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 also 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 (p.192). Our processed diet sends us on a daily rollercoaster of spiking and crashing blood sugar, which is only 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 raise the risk of developing ADHD and, later, dementia.

ADHD diagnoses in the UK have soared. For every child diagnosed in 1986 there are now 100 children in this position. Between 1998 and 2004, the number of children prescribed stimulants doubled. Studies now indicate that less than 20%–30% of ADHD diagnoses are likely to be due to factors that are biological or genetic. We need to address what part our environment plays if we are to fully deal with this attention crisis.

PLAYING FREELY

Children need to play to develop social bonds, creativity, and imagination, and learn how to experience joy and pleasure. Playing builds the foundation of a solid personality. We are much less likely to 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 an 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’ (p.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 our 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 seizing attention? Hari believes that we must now re-learn to focus together or face the fires alone.

Footnotes

  • 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. Br J Gen Pract 2018; DOI: https://doi.org/10.3399/bjgp18X697709.

  • This review was first posted on BJGP Life on 23 Jul 2023; https://bjgplife.com/stolen

  • © British Journal of General Practice 2023
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British Journal of General Practice: 73 (734)
British Journal of General Practice
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Books: Stolen Focus: Why You Can’t Pay Attention
Emma McKenzie-Edwards
British Journal of General Practice 2023; 73 (734): 417-418. DOI: 10.3399/bjgp23X734877

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Books: Stolen Focus: Why You Can’t Pay Attention
Emma McKenzie-Edwards
British Journal of General Practice 2023; 73 (734): 417-418. DOI: 10.3399/bjgp23X734877
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