Do you have an urge to respond immediately to the sound of an incoming email? Do you feel anxious when your smartphone is not close by? Has it become a reflex to pull out your smartphone while waiting in a checkout line? This article explores why our brain is prone to distraction, why we crave information and novelty, how high-tech tools amplify our distractibility, and what we can do to attenuate the risk of excessive information foraging. Evidence-based studies provide suggestions for claiming back time and resisting distraction.
How serious is distractibility in day-to-day life?
More and more people experience anxiety when they turn off their phone in the middle of the day. Some even suffer from “nomophobia,” the anxiety that comes from being out of mobile phone contact.1,2 The average office email goes unanswered for only six seconds. More than 50% of adults check their smartphone the moment it makes a sound, 42% use it to kill time and avoid quiet reflective moments, 12% use it in the shower.3 In colleges, the use of technology in the classroom leads to multitasking and task-switching, resulting in lower test scores and increased anxiety and dissatisfaction with life.4,5 In the workplace, it takes 20 minutes to refocus on the task at hand after interruption by and replying to an email.1
A quick and informal survey of my Twitter followers revealed that 75% will check their smartphone when waiting idly in a lineup.
Evolution and neuroscience
Humans crave information and forage for it, just as they used to forage for food in ancient times.1 In fact, survival depended on acquiring both: we needed information to find the best food sources and to figure out where predators might be lurking. The same ancient cerebral cognitive control circuitry is activated whether it is food or information that appears as a novelty.6
Every time something new appears, our dopaminergic reward system is activated and we feel a thrill; repetition of such thrills can lead to addiction by consolidating the reward circuits in our brain.7 Imagine now how quickly this occurs with a smartphone, the Internet, and social media. “Likes,” “shares,” and “retweets” also boost dopamine rewards, contributing to a pattern of reinforcement that leads to habit formation.8,9 In extreme cases, brain restructuring can take place: the fronto-striatal-limbic brain regions tend to have a smaller volume of grey matter in the subgenual anterior cingulated cortex, a key region for monitoring and control in neural networks underlying addictive behaviour.10 Top
Goal setting, cognitive control, and distractibility
The brain parts responsible for goal setting evolved with the appearance of the neocortex, the pre-frontal cortex in particular, while cognitive control has remained similar to that of lower vertebrates. As a result, we are not capable of either concurrently managing competing goals or switching rapidly between tasks.
In The Distracted Mind: Ancient Brains in a High Tech World, neuroscientists Gazzaley and Rosen describe the science behind this very well.1 Poor cognitive control leads us to be easily distracted from the goals we set, which is aggravated by the exponentially increasing amount of information we have access to (Figure 1). As we forage for more and more information, we solidify our reward circuits and become less and less capable of concentrated and focused “deep work.”1,2 Our continuous drive to find information is making us very distractible at best and addicted to information foraging in the worst case.
Taking action against distractibility
Two ways to combat distractibility are boosting cognitive control and changing behaviour.
Physical exercise has been demonstrated to be the most effective tool for increasing cognitive control.11-13 fMRI studies show that exercise increases prefrontal cortex activity and decreases the impact of distraction on task performance.14 In adults aged 55–80, combined strength and aerobic training improved cognitive control more than aerobic exercise alone, and the longer the training, the greater the effect.14 Among 144 people aged 19–93, performance on a cognitive test improved immediately after a single 15-minute bout of moderate-intensity stationary cycling.12
Meditation increases the ability to sustain attention, speed of processing, and capacity of working memory.15 A range of techniques — from weekly three-hour classes, to daily 30-minute meditation, to mindfully monitoring one’s breath, thoughts, or sensations in the moment — have been studied. Despite some methodological limitations, there is mounting evidence in support of meditation for boosting cognitive control.1 “Productive meditation” might also help with focus. It involves a period during which one is physically, but not mentally, occupied and a wandering mind is returned to focus, as in mindful thinking.2 An example would be to focus on a single, well-defined professional or personal problem while running or cycling.
Brain games use adaptive cognitive exercises, in which the tasks become gradually more difficult as the participant’s performance improves. Computerized software algorithms adapt the task challenge in real-time based on recorded performance metrics.16 Similarly, well-designed video games might also amplify cognitive control.17 While brain games focus on a particular cognitive skill, video games, even those designed with cognitive control in mind, do not focus on individual skills specifically. Although several games have been developed and studied rigorously, they are not yet commercially available.1 Top
There is only weak to moderate evidence that traditional education, repeated exposure to nature, drugs, or neurofeedback boost cognitive control.1
Behavioural changes (Table 1) can decrease our exposure to and interference from high-tech information tools. Internal interruptions can be reduced by increasing meta-cognition (awareness) and by decreasing boredom and anxiety. External distractions can be decreased by limiting access to the sources.
Increase meta-cognition: Lack of (self) awareness leads to a continuous state of partial attention. Research shows that those who think they are best at multitasking are actually the worst in lab experiments, and their perception of being good at task-switching and multitasking is not grounded in reality.18
Simple tools can heighten our awareness. Schedule in advance when you will use the Internet, and then avoid it altogether outside these times, no matter how tempting. Keep a notepad next to computers and record the next time you are allowed to use the Internet. The idea behind this strategy is that the use of high-tech information tools does not itself reduce the brain’s ability to focus; it is the constant switching from low-stimuli, high-value activities to high-stimuli, low-value activities that teaches our mind to never tolerate an absence of novelty.2 By creating a visual scorecard, you bring your Internet use into your awareness. Several apps are available to help, for both smart phones and computers: Focus Keeper, Moment-Screen Time Checker, Rescue Time, among others.1 Some of these measure how much time you spend on your device(s); others also measure how much time you spend on various websites or social media.
Reduce accessibility: Completing work and projects, especially on a computer, is a challenge because of the constant availability of more and more information. Set up your environment to reduce the chances of being distracted or interrupted. Work with a single screen and open one website at a time. Eliminate the use of tabs whenever possible and close them rather than minimizing them for later reference.1
Remove the temptation to respond to every “ding” alert of an incoming message. Checking electronic communications should take place only at certain designated times of the day and not be constant interruptions. Studies indicate that people who limit their email work to three times daily, rather than responding immediately, suffer less stress and experience other physical and emotional benefits. Some apps, like Focus, can block or limit time spent on certain websites, while Concentrate and Think help specifically on sites related to social media. Finally, turn off the alarm on your email while keeping the phone component active so that people who need to reach you can do so.
Reduce boredom: Being alone with our thoughts has become boring for many people. Focusing on one perhaps less exciting assignment or project is becoming more difficult while novel and fun information is only a click away. Don’t use the Internet to entertain yourself. Brief mental breaks can be restorative and help you stay focused. Apply the 20–20–20 rule by standing up and taking a 20-second break every 20 minutes to look 20 feet away. Changing your focal distance from inches to feet shifts some cerebral blood flow to brain areas not related to constant attention. Although not conclusive, research shows that spending 10 minutes in a natural setting or even watching nature pictures can be restorative in terms of cognitive function.1 Top
Talking to another human being, even on the telephone, productive meditation, or any other short relaxation method will help you re-engage with greater arousal, more capacity for attention, and less susceptibility to distraction and interruption.1,2
Reduce anxiety: Technology has induced anxiety associated with fear of missing something, which then causes you to interrupt your work and reorient your cognitive resources to the detriment of your performance. The strategies discussed under “Increase meta-cognition” and “Reduce boredom” can also be applied here. In addition, set expectations by informing others that you have a plan in which electronic communications will happen at pre-established intervals. A simple note at the bottom of all your outgoing emails, stating that you will reply at certain times is sufficient. As little as 12 minutes of exercise, productive meditation, and mindfulness all contribute to reducing anxiety.1
In summary, changing behaviour is not easy, but it is doable. Many physicians and physician leaders are continuously exposed to quick, acute changes in the health care system to accommodate patient needs. It is tempting to extend one’s response to that fast-changing, attention-switching professional world into one’s personal life. Our fast-paced profession and the health care system have made us susceptible to interruptions and distractions, and technology’s impact on our distracted mind amplifies the risk of overindulgence.
It is a real risk, and as an active “twitterite,” I have experienced it. Just by increasing my own awareness and monitoring access, I have freed up more than an hour daily to be enjoyed in more productive and healthier ways. Top
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18.Sanbonmatsu DM, Strayer DL, Medeiros-Ward N, Watson JM. Who multi-tasks and why? Multi-tasking ability, perceived multi-tasking ability, impulsivity, and sensation-seeking. PLoS ONE 2013;8(1):e54402. doi: 10.1371/journal.pone.0054402
Johny Van Aerde, MD, PhD, FRCPC, is editor-in-chief of the Canadian Journal of Physician Leadership and a former president of the Canadian Society of Physician Leaders. Top
This article has been peer reviewed.