Stay Focused

Attention and focus are big problems for a lot of us.  I can’t tell you how many patients I’ve seen that at some point say “I swear I think I’m ADHD.”  Most of the time, they’re only sort of kidding.  ADHD, or Attention Deficit Hyperactivity Disorder, is a condition that presents in childhood.  Sometimes people aren’t diagnosed until they are adults, but they will usually be able to look back and see that the condition was always there.  So what about people who notice a significant decline in focus as an adult?  Poor concentration is a common symptom.  It can occur as part of a mood or anxiety disorder, or a physical condition like sleep apnea.  With any major change in concentration or memory, it’s important to rule out these types of serious causes.  Most of the time, however, it’s a symptom of a stressful lifestyle.  Yes, good old stress, showing us yet another reason why we need to learn to manage its effects on our lives!

Stress affects focus and concentration in a number of ways.  Physically, it can affect our sleep, causing daytime fatigue.  We can’t focus on writing a detailed report at work if our mind is spending all its energy trying to stay awake.  Stress also causes the release of hormones that trigger the fight or flight response.  Physiologically, we are being primed to run or turn and fight our attacker.  Our brains are scanning for threats and escape routes, and literally can’t stay focused on one task when that is going on.  Obviously, we will need to relax in order to improve our concentration!

Distraction is another reason for poor focus.  We lead busy lives, and are often trying to multi-task in order to accomplish everything.  This can increase stress, but it also ensures that we aren’t fully attended to any one thing at a time.  Multi-tasking can also create an over-stimulating environment, as we watch TV while trying to read an article and wonder why we can’t remember anything we’ve read.  I also see a common problem with procrastination.  If you’ve ever put off an important assignment, then worried about it in the back of your mind all day long, you know how distracting it can be!

So, based on the reasons for lack of focus listed above, here are some ways to improve concentration:

1. Reduce stress.  Since stress is the most common reason we can’t concentrate, this goes without saying!

2. Get enough sleep.  And if you’re tired and losing focus, try taking a short break.  Take a walk, call a friend, or just have a cold drink.  Your alertness may improve, and your focus along with it.

3. Single-task.  Do one thing at a time, and don’t put things off.  You are much more likely to stay on task and accomplish everything on schedule.

4. Meditate.  I know, this is my answer for everything, but hear me out.  iRest, Mindfulness Meditation, and Transcendental Meditation have all been shown to have profound relaxation effects on the body  (see number 1).  They have also been found to improve concentration, separate from their impact on stress.  Meditation actually trains your brain to stay focused on one thing.  So, we meditate to relax the body while we strengthen our attention at the same time.  Beautiful!

Lack of focus is common, and there are often many reasons for it.  Sometimes we need to look at the bigger picture of the stress and demands on our lives to truly discover why we can’t concentrate.  The treatment should fit the cause, and therefore my prescriptions most often include the lifestyle changes listed above.  It may take some work to accomplish, but the benefits will extend into your whole life.

Stop the Mindless Eating

I once saw a tongue-in-cheek list of ways to avoid gaining weight.  It included things like “Always eat standing up” and “Eat the broken cookies because the calories have all leaked out.” Like all good jokes, it was funny precisely because it contained so much truth.  A lot of us have complex relationships with food, to say the least, and have developed habits of mindless eating that aren’t healthy or helpful.  This can vary from silly “rules” for eating, to snacking out of boredom, to eating on the run.  All of these have in common a pattern of disinterest in just how and what we put into our bodies.  I have to admit to standing at the counter and “cleaning up the edges” of the pan of brownies, believing I’m only eating a small amount.  But studies have shown that this type of behavior actually results in eating more, rather than less.  The worst part is, I don’t even realize it because I’m not being attentive.

Mindless eating also includes something I’ll call the multi-task meal.  You know, where you’re really too busy to stop for lunch so you eat at your desk while answering emails.  Or while driving.  Or while on a conference call.  The multi-task meal means eating has been relegated to just another thing on the to-do list.  I can say from experience that food eaten this way is not enjoyed.  In fact, it’s probably barely even tasted.  As eating this way becomes a habit, it becomes less important what we choose to eat.  Clearly this is a stuff-and-go operation, so quality of taste and nutrition aren’t a priority.  Once we lose sight of the value of the food, the simple pleasures of a meal are ignored altogether.  We eat on autopilot, whatever we can get and eat the fastest so we can get back to doing something more important.  Yikes!  What could be more important than giving our body the fuel it needs to be healthy?

We all know the pitfalls of a fast food diet, including obesity and heart disease.  Mindless eating also has a negative impact on health.  As I mentioned above, we may choose less healthy foods, but we also tend to eat more, and more quickly, when we aren’t paying attention.  This can result in indigestion, heartburn, weight gain and irritable bowel symptoms.  The rushed feeling of a multi-task meal can also increase feelings of stress.  Meal times were designed to be a break in the action of the day.  Our bodies actually need to be in a relaxed state to even digest food, so eating under pressure works against our most fundamental biology.

So how can we take back mealtime?  One way is to apply mindfulness concepts to eating. Mindfulness means being fully present, and at home in all of our senses.  We cannot be aware if our attention is divided, so the first thing to do is simply eat, with no distractions.  Turn off computers, phones and the TV.  If possible, leave the office altogether at lunch time and eat in a relaxed setting.  Focus on the sensory experience at hand, including the smell, taste, and texture of your food.  Eat slowly, and put your fork down between bites.  Savor the meal and enjoy the time out in the day.  Eating this way has been shown to allow us to recognize when we’re full, so overeating becomes less likely.  Some studies have shown this can lead to weight loss.  These changes also decrease the stress response at meal time, so digestion will improve.

We can start with meals, and then bring mindfulness to all of our eating.  I can start by assessing why I’m choosing to eat in the first place.  Am I hungry?  Do I just want something sweet?  Or am I bored and lonely?  Awareness of my motivation should drive my next action, and I can be sure I’m making conscious choices.   Then, I remind myself that every bite of food is worthy of my full attention.  Therefore, every snack should be put on a plate and eaten sitting at the table.  No more mindless grabbing of food, I eat slowly, savoring the experience.  Over time, these habits create a consistent pattern of awareness that will improve health and well-being.  Eating should be a multi-sensorial experience, a pleasure for every human being.  Mindful eating can return us to that state.

Leave it Behind

Our brains are designed to store information as memories.  Some from recent moments, some from the remote past.  Our brains are also designed to analyze, judge and stew over things.  If the mind isn’t actively engaged, it may turn to the memory files for something to chew on.  Then, we may find ourselves replaying a situation again and again, pondering what we could or should have done differently.  Sometimes it’s like a song on constant repeat.  Why can’t we just let it go?

I love a good story, so I’ll share a Zen Buddhist tale I heard recently that illustrates this tendency.  Two monks were walking home from a journey.  They came to a river, and saw a lovely young woman standing by the edge.  It was clear she was afraid to cross by herself.  The younger monk crossed to the other side, ignoring her.  Then the elder monk picked her up and carried her safely across.  He placed her down and the two monks continued on their journey.  As they walked, it became clear that the younger monk was upset.  Finally, he could no longer contain himself.  “Why did you carry that woman? You know it’s against our vows!”  The elder monk looked at him and said “You’re still thinking about that woman?  I left her back by the river.  Why are you still carrying her?”

The younger monk was dragging along his irritation and upset about a situation that was already over and done with.  He couldn’t let it go, and he walked for miles allowing the past to hold onto his emotions.  The elder monk, however, was peaceful and content on his journey.  The past didn’t enter his consciousness, and the young woman stayed by the river.  So how do we learn to leave it behind?

The little every day upsets that come and go can get stuck on replay.  The best way to leave them by the river is to act like the elder monk.  Return to the present moment.  Take a deep breath, feel the breeze on your skin.  Hear the birds singing in the trees, and smell the freshly cut grass.  There is no room for the past when we focus on the beauty of right now.  The more we practice mindfulness, the easier it becomes to stay present.  Our minds aren’t muddled by the little things, and we can more easily see the big ones that need to be addressed.

The past is there to teach us something. Why else would we need to store memories? I learn that a hot stove will cause a burn, and I know not to touch it again. When our minds stay fixed in the past, however, we are preventing ourselves from moving forward. I can’t change something that happened last week or last year. I can learn from it and change my behavior so I act more according to my values in the future, if that’s what I need to do. Then I need to release it. If it comes back again, I need to reassess if I’ve learned all I need to from it. This can be done with a meditation technique, such as iRest, or with journaling, or the support of a good counselor.  Eventually we can work through the file of memories, separating them from the emotional baggage that drags us down.  The we are free to continue our journey home.

Another Year Older

Over the last several months, many of my friends have entered a new decade of life.  Soon, it will be my turn to join them at… that certain age.  Birthdays aren’t usually that tough for me, but this one has me thinking a lot more.  Getting older is inevitable, but the disparity between how old I feel and my actual age keeps getting bigger, and I find myself focusing more on the number.  I’ve heard similar comments from friends, as they approached their own big day.  There seem to be some common patterns as we are reminded of aging another year.

Birthdays naturally make us reflect on our lives.  We review where we’ve been, what we’ve accomplished and if we feel we are a success.  This can create a positive reassurance or a drive to meet goals.  More often, I see it foster a dissatisfaction and worry that we aren’t where we’d like to be.  We focus on the things we don’t have, or the childhood dreams we can never achieve, and are left down and melancholy.

This goes along with another tendency I’ve observed, a fixation on the past.  It goes something like this: Remember when we were in college and so carefree?  How I wish I could go back to those days, or at least that smooth, unlined face!  Again, the focus is on what we don’t have, and can never have again.  Namely, our youth.  Suddenly I’m even more aware of the process of aging, and I’m desperately seeking the latest anti-aging creams.  I certainly don’t feel happy!

Both of these patterns of thought will ultimately lead to a low mood, because they keep the mind focused on a negative space.  We see only what we lack and what we feel we should have. So how can I weather another birthday with grace and good humor?  I plan to apply lessons learned from reading positive psychology books.  I will focus on the good things instead of the bad.  Simple, right?  Instead of noticing what is missing, I appreciate what I have.  Then I see abundance instead of what is lacking.  When I take pleasure in what I have –  even the small things – I am satisfied.  Nothing I truly need is missing.  As my birthday approaches, I am counting my many blessings rather than the number of candles on my cake.  I may still notice my age at times (the loud popping of my knees at the start of yoga class, for example), but then I appreciate all the things my body can still do well.  It takes practice to redirect my focus, just like any other learning process.  Luckily, you can still teach an old dog new tricks!

Just Say No

We lead busy lives these days.  Family, work, home, kids’ activities, these all take up a lot of time.  Many people tell me that they get over-scheduled and don’t have any down time.  Some of the things on the calendar are priorities, and some are fun.  Others are things they’d just as soon avoid.  So why keep doing them?

One reason is that it can be difficult to say no.  Women, in particular, seem to struggle with this.  We want to please people, and we want to be liked, and saying no doesn’t go along with these goals.  However, saying yes when we want to say no puts us in the position of agreeing to things in an effort to be liked, rather than a genuine interest.  Not only will the activity feel like a burden, we may end up resentful or irritated by the whole thing.

When I agree to something out of a desire to please others, I’m putting myself second.  I’m effectively saying the person asking is more important than me, because I’ve accepted their needs as a priority over my own.  If I do this enough times, I demote myself further and further down the list.  I may eventually feel I don’t even have choices anymore!  Other people will certainly pick up on this, and you can bet there will be some who will take advantage of it.  If you wonder why everyone always asks you to do things, look at your track record.  Could it be because you always say yes?

Now I know people who truly don’t mind heading every committee, and I know others who enjoy having the entire neighborhood in their backyard every afternoon.  If you are that person, then say yes!  If, however, the activity leaves you feeling empty, or worse, resentful, explore your reasons for agreeing to do it.  There are clearly duties that are annoying but obligatory.  Other times, I don’t relish the chore, but want to help the person asking.  If my reasons for accepting are in line with my own priorities, I will say yes.  Otherwise, I should politely decline and allow someone who is truly committed to take over the task.

It won’t be easy the first several times you say no, especially if people expect you to say yes.  I find it best to be brief, without a lot of excuses.  I prefer to simply say “I’m sorry, but I’m not able to do that at this time.”  Polite, succinct, and no room for arguing.  It quickly conveys that my reasons for declining are my own business.  Practice saying it, and remember that you don’t need to justify every no.  In the long run, your schedule may not get any lighter, but it will be filled with things you truly want to do.  You will also be treating yourself with the respect you deserve.

Tough Lessons

It’s pretty natural as human beings to want to be liked.  We are social creatures by nature, so fitting in is practically a genetic priority.  We also learn at a young age that not everyone is going to like us.  And it’s such a fun lesson, we get to learn it over and over throughout our lives!

I can remember a dozen painful rejections from childhood off the top of my head right now: the party I wasn’t invited to, the boy who didn’t want to date me, or the popular girls who didn’t welcome me to their lunch table.  I’ve seen my kids go through similar situations already at their young ages.  As an adult, the rejections can be personal or professional, but the hurt is often still there.  It’s never easy to be left out, judged unfairly or treated meanly no matter how old we are.  My tendency in these situations is to question myself.  What could I have done to upset them?  Did I say something wrong?  How am I to blame for this situation?  I know I’m not alone in this pattern because I meet a lot of people in my line of work.  Even the most confident individual will doubt themselves in the face of social rejection.

Every time it happens to me, I have to remind myself of a few things.  First, I cannot control other people.  I can’t change their behavior or their thoughts, and they get to choose their own opinion of me.  Second, more often than not, someone else’s opinion of me has very little to do with me.  Think about all the reasons someone may not like another person.  There’s jealousy, blind prejudice, and simply meeting them on a really really bad day.  People also come carrying their own baggage, and past relationships may influence how we feel about present life, whether we like it or not.  Think: I don’t like you because you unconsciously remind me of my really mean second grade teacher.  None of those reasons have anything to do with me as a person, so I shouldn’t allow a rejection to fuel self-doubt.

The last thing I try to remember is that all I can do in any social setting is to present my best self.  I can be aware in every conversation and look for cues on how to connect with the person across from me.  I can try to meet their needs by listening at least as much as I talk and by staying mindful with my speech and behavior.  Lastly, I can speak the truth in all situations, from my heart.  If I’ve followed all of these principles, I’ve acted with integrity.  Then I never need doubt myself, no matter what the outcome.  If someone else doesn’t appreciate my best self, then it really is their problem, not mine.

What’s the Rush?

I was on vacation last week.  We were very busy, but we didn’t have a set schedule.  I noticed something interesting a few days into the trip.  Even though there was nowhere we had to be at any given time, I still found myself rushing to get places.  I was hurrying to get from one park to the next, and even irritated if we were in a long line of cars.  I wasn’t late for anything at all, so what was going on?

We live in a fast-paced world, and a lot of our time is over-scheduled.  This leads to a constant sense of urgency – to get somewhere, to finish something, to move on to the next big thing.  It’s so ingrained in us to rush, we can’t shut it off when we finally get some down time.  And as our bodies hurry from one place to the next, our minds jump ahead, too.  As I waited in line for one attraction, I was thinking and planning about what we were going to do next.  I finally realized that my push to get to the next fun thing was sucking the pleasure from the experience, because I wasn’t present to enjoy it.

Vacations always seem to teach me something.  Last year I learned to stop counting down the days and dreading the end of my time off.  This year I had to force myself to slow down, to look around and notice things, to hear music and laughter and taste my food.  I had to let go of the need to do everything in order to savor the experience at hand.  I can’t say I walked more slowly, but I allowed myself to rush with the thrill of the moment, rather than the need to check another item off the agenda.  I think it’s always easier to remain mindful when I’m relaxed, so vacation is the perfect time to practice.  I’m happy to take this lesson back into my real life this week: slow down and enjoy this moment, the present is where the excitement lies.

Accept Yourself

Self-esteem has been a major buzz-word for decades.  We focus on the positive traits and achievements of our children to show them they are valuable, so they can have a healthy level of self-esteem.  There’s nothing wrong with that, in fact, I think it’s important for people to recognize the good in themselves.  But what about the things inside us we don’t like so much?  Self-esteem can focus so much on the positive, it completely ignores, or even denies the existence of, the negative.  Mistakes, failures, bad thoughts or choices, these are certainly a part of us all.  Can I still feel good about myself when these shadow traits rear their heads?  Maybe not.

Self-esteem is a fragile thing.  It takes a hit when we discover we aren’t the best, or we do something we regret.  Mistakes can make us doubt any positive thoughts we had about ourselves and our abilities.  But if, instead, we accept ourselves as we are, we can weather the ups and downs of life knowing we are ok.  According to the yoga tradition, we are all perfect at our core, just as we are.  We don’t have to be fully enlightened to learn from that belief.  I can live my life realizing that good things and bad will come and go, but I accept myself regardless of my circumstances.  I will still feel pain or loss, but I know that beneath that I am still ok.  Aside from a lifetime of meditation and introspection, how can we work towards self-acceptance?

It starts with allowing all aspects of ourselves to be present.  Don’t deny feelings or emotions thought of as “bad” and don’t cling to those that are “good.”  Everything is welcome, without judgement.  Also we have to give ourselves a break.  Ok, a lot of breaks.  We work toward viewing our choices with compassion and forgiving ourselves liberally.  After all, we really are doing the very best that we can in every situation.  Try repeating that to yourself the next time you make a mistake.  I find that regret and guilt weaken substantially in the face of such understanding.

A funny thing happens when I become more self-accepting.  I feel better about myself, but I also become more compassionate toward others.  I recognize other people are doing their best with what they’ve been given, and I remember that I can’t possibly know what challenges they’re facing.  Imagine a world where we all truly believe that of others.  Empathy and forgiveness instead of judgement and hate, and the recognition of other human beings trying to live their best life possible.  It starts with acceptance of ourselves.

Be Self-Centered

I have a lot of patients with chronic neck and shoulder tension.  One woman who came to see me for irritability and depression described her nearly constant pain, headaches and restless sleep.  I asked her what helps with the pain, and she said regular massage had totally resolved it in the past.  Of course my next question was why aren’t you getting massages now?  What followed was a long list of reasons, which boiled down to the fact that self-care was near the bottom of her list of priorities.  Work and family always beat out her own needs, even when she was clearly suffering.

Many of us believe that an hour out of our week for a massage, or exercise, or a yoga class, is an hour that should be spent doing something more important.  Like finishing that report at work, taking the kids to another activity or scrubbing the bathroom.  Time spent addressing our own needs is time wasted.  This type of thinking often obscures a deeper belief: that I’m a bad or selfish person if I take time for myself, or that I’m not worth as much as everyone else.  But I’m here to tell you that not only are you worth it, your self-care is essential to the success of everyone else you’re supporting.  There is a reason the airline video tells you to put on your own oxygen mask before helping others.  If you are not operating at full capacity, you can’t possibly care for anyone else.  Think of my patient.  She is irritable and depressed because she is in pain.  She isn’t sleeping because of the pain which makes her more irritable and depressed.  In this frame of mind, she is more likely to lose focus and make a mistake at work, or snap at her kids when they ask for help with homework.  The very things she finds most important are suffering because of her pain and stress.

I am going to suggest another radical idea: be a little more self-centered.  Focus on your own needs first, so you will have the energy and strength to devote to your other priorities.  Being self-centered means resting when you’re tired and getting enough sleep every night.  It means eating healthy foods, exercising your body, and doing something to relieve stress like meditation or yoga.  It also means going to the doctor when you’re due for a regular physical.  You may be reading this list and thinking well, duh!  But how many of these things get pushed aside on a regular basis, because they just don’t seem as important as the other items on your to-do list?  Being self-centered will help ease stress and fatigue, and improve a sense of well-being.  Practice addressing the needs of your body and soul, and see the difference it makes in the rest of your life.  I know what I need to do for myself each day, but sometimes I need to remind myself that I am worth that effort, because a lot of people are counting on me, just like people count on you.

Release Expectations

I use my Google calendar to record every appointment and event.  I make sure to allot plenty of time to drive to work, and I check the weather so I know how to dress myself and the kids.  All of this makes me feel in control.  But what about when things don’t go as expected?  Last week I faced waking up to a sick child, finding the dog in a pile of torn up tissues when I was ready to walk out the door, and forgetting a container of chicken on the counter that I’d planned to use for dinner.  No huge emergencies in the grand scheme of things, but none of these were in my plans!  How I handle these kinds of curveballs is directly related to how attached I am to my expectations.

Let me explain.   If I live my life believing I can actually control it, then I also believe that things ought to happen exactly as I expect they will.  My calendar contains the events of the day, recorded at the times they will actually occur.  When that inevitably doesn’t happen, I will be frustrated and angry because my thoughts will spin a tale of how unfair this is and how it shouldn’t be happening this way.  Or, I’ll be anxious and overwhelmed as my mind carries on about how I’ll never get everything done now.  My attachment to expectations has successfully ruined my day.  I may react by trying even harder to control tomorrow!  Conversely, if I do my best to plan ahead, but recognize that I don’t actually know what is going to happen each moment, my mindset will be completely different.  Things will come up, but I can watch each situation arise and address it as it comes.  Then my thoughts aren’t tied up in fear or frustration, and I can focus on solutions.  Two opposite attitudes with two different emotional outcomes, like two different ways to wade in the ocean: One stands rigidly, waiting to be knocked over by the waves, while the other floats on top.

Trying to control life is as futile as trying to direct the waves of the ocean.  That doesn’t mean we should give up planning and organizing, it just means we have to recognize the limits of our control.  Set up a daily schedule, but keep an attitude of acceptance when things come up.  What happens when I’m trying too hard to control life?  I feel a tightness in my belly and a pounding heart while I have repetitive thoughts about forgetting something important.  When I recognize these feelings, I know I have to stop and take some deep breaths.  I practice lengthening the exhale, until it’s double the length of my inhale.  Then my body becomes calmer, my mind more present.  My breath reminds me to release my expectations and ride the waves of each moment.  Mindful living means acceptance of this moment, as it is, rather than wishing it would turn out the way I expected.