11/08/2021.
Attention. Distraction. Return. Repeat.
“One day Alice came to a fork in the road and saw a Cheshire cat in a tree. “Which road do I take?” She asked. “Where do you want to go?” was his response. “I don’t know,” Alice responded. Then said the cat, ‘‘it doesn’t matter.”
Please pay attention.
In 1995, the late Barney Hurwitz phoned and asked me to set up a Stress Reduction Clinic at the Milpark Hospital, Johannesburg. Barney, a childhood friend of my father, was a successful pharmacist-turned-hospital entrepreneur. The Rand Clinic in Hillbrow was his first purchase; the Milpark the second. Subsequently his company, Clinic Holdings owned dozens. Then the entire enterprise was acquired by a consortium to form the current JSE listed Netcare.
I accepted the challenge, even though no such clinic existed in the country. What to do? I searched for the best Stress Reduction Clinic in the world, and found a gold mine of experience in the United States of America.
Based in Boston, Massachusetts, Jon Kabat-Zinn set up the clinic in 1979, with the 8 week Mindfulness Based Stress Reduction course (MBSR) as its central axis. My timing was fortunate as he just published the book Full Catastrophe Living a few years before, to critical acclaim. In the thick book, Jon included detailed descriptions of the MBSR program, a model to understand illness, stress, and pain, and it’s application of mindfulness in managing the full catastrophe of life.
Mindfulness meditation entered my lexicon, and have explored the practice and theory ever since. I have followed its scientific findings and emergent philosophy; and read all the works (podcasts, books, videos, zoom webinars) of Dr Kabat-Zinn and recently completed his brilliant MasterClass course on Mindfulness.
Fast forward 20 years, and the journal Scientific American published an article detailing four discrete areas of the brain that are activated when meditating.
The paper provides a logical circle where one can pin definitive insights and application beyond formal meditative practice.
To start the meditation circle, one needs to focus on ‘something’ - the breath (the most common), a flickering candle, a body part (for example, the right foot), sounds, or sights. I will keep coming back to this point of focus (!)
Second, invariably, after a few moments the ‘mind’ wanders off in many different directions away from the focal point. This brain area that now lights up is the default mode network, where distractive (and sometimes destructive) mental activities play out.
The default mode network is the cerebral forum where your conversations of past and future play out, shifting concentration away from the zone of experiencing the blooming of the present - what intensive focus does. The power of now.
The default network can be blessing or a curse. The blessing of daydreaming, of doing something else besides focusing can provide answers to questions, solutions to problems. Some speculate that this default area is where the embryonic ideas of Albert Einstein originated.
The curse is getting locked into an internal battle between what could have/should have been done - the past (embedded in a stormy sea of emotions: sadness, guilt and shame), and what might happen (the fear of uncertainty). It is a toxic brew that leads to brain warming.
The third area of activation is recognizing that the process of distraction is occurring. So two sources of information are needed for this recognition: the choice of focus (say, the sensation of breathing) and the content of distraction (what is for dinner tonight). Externalized - the right hand holds the intended object of attention; the left hand the process of distraction; and the eyeballs, this third area, are the adults in the room.
The impulse of recognizing the mismatch, the tension, between focus and distraction is where mindfulness practice is where it is most valuable. Over and over again it occurs throughout conscious life - focus requires effort, distractions less so. The quicker you realize the distractions, the easier you can return to your focal point (provided you have a point of focus. It has taken me 25 years of practice to realize and fully embrace this insight.
The fourth area of the meditation circle is the ability to (gently) return to the beginning (focus), and start again. Without judgement, like a loving gandparent. Constantly re-calibrating the compass.
To recap: four functional cortical areas of the meditative cycle:
1). Attention
2). Distraction
3). Recognition
4). Return
It takes 10,000 hours of practice to achieve top tier expertise in the practice. But it’s application outside of formal practice, in managing the full catastrophe, are profound. Let’s focus on this magisterial idea.
Although now I understand it’s utility in the formal eight week program, the four part practice has enormous influence in all our daily endeavors. I was initially surprised how many patients I interviewed did not have a focus in their lives, and were caught up in paralyzing, recurring life-numbing distractions.
Therefore, the third stage of recognition could not occur! They did not have a focus to compare their distractions against. And could not return as they had no where to get back to. the brilliant insight of the conversation in Alice in Wonderland:
An Uber ride taught me this four part process, so well. Uber, using GPS technology, knows exactly where your current location is through your cell phone position. But what it does not know is where your destination might be. Once it knows where you going, with this info, it can plot the shortest route between the two (where you are and where you going), estimate the cost and time, and find the nearest driver.
Here came the epiphany!
On my first Uber trip, after a few minutes, I suggested a short cut to the driver, who immediately deviated from the GPS designated map.
Within seconds, a female voice, calmly stated: “Recalculating.” And started to announce new instructions - “ and in 100m, turn left at the stop street.”
There, in that moment, the four way internal circle of mindfulness meditation was playing itself in real life, in front of my eyes:
1). Focus (clear destination)
2). Distraction (short cut suggestion)
3). Recognition (recalculating)
4). Return (new travel route to destination).
Brilliant! A short Uber experience provided me intense clarity into the thousands of hours of reading about and practicing meditation. It is much, much more than sitting quietly, eyes closed, observing my in-breath and out-breath. It is the quintessential brain gym fitness circuit.
Mindfulness, then, is ultimately a mental flexibility skill-set to realign focus with values, to step back, reflect and resharpen your vision and implement the mission, away from all those pesky distractions.
I love it when scientific findings prove ancient wisdom! And a real life experience connects the two.
So, please learn to pay attention. An investment that keeps giving.
(C) Dr Jonathan D Moch
Psychiatrist, writer.
Website
www.jdmoch.com
Core Professional Interest
Cognitive-Behavior Therapy“Yes, You Can!”
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Overall Vision
Uplifting (ExtraOrdinary) People To Achieve The Impossible.
Links
1). Jon Kabat-Zinn
https://en.m.wikipedia.org/wiki/Jon_Kabat-Zinn.
2. Scientific American
https://www.scientificamerican.com/video/how-does-meditation-change-the-brai2013-10-30/
From a friend
Thanks for your letter No 20.
I start and don’t finish 20 things in a day.
Is it because I have been interrupted and the interrupter wants my attention now, is it because I don’t focus, is it plain old age or is it because I want to make everybody happy?
Just thinking.
Estelle
From a friend
Hi Dr Moch,
I would like to tell you how much I enjoy reading your 'Letters from a Psychiatrist", and in particular the one I have just read on "Loneliness, Mindfulness & Togetherness".
Your words resonated with the story of my life where I was extremely lonely for most of my life (even in a crowd), to now absolutely relishing my alone time in my own company.
This journey has taken me over 20 years, and my journey is still in progress.
I am currently reading a book by Dr. Caroline Leaf, a neuroscientist and communication pathologist whose passion is to help people see the power of the mind to change the brain, control chaotic thinking, and find mental peace.
The name of the book is 'Cleaning Up Your Mental Mess' which was published earlier this year.
As you are a keen reader, I highly recommend you put this book on your reading list.
You will find that Dr Leaf has a lot in common with the way you think.
.
That's all from me and I look forward to your next letter.
Kind regards,
Jenny Templemore-Walters
PS: I think you should one day publish your letters in a book to be sold commercially. They make for interesting and thought provoking reading. :)