Richard G. Petty, MD

Combat Stress

The British Ministry of Defense has announced that it is going to pardon all 306 soldiers shot for cowardice during the First World War.

This is the culmination of a campaign that has been going on for years, after it was discovered that most of these soldiers were actually suffering from “shell shock.” From the historical records it seems highly likely that this was actually post traumatic stress disorder (PTSD). Some people have said that there’s no point in issuing posthumous pardons ninety years after the events.

I don’t agree. It’s virtually impossible for us to imagine the horrors of trench warfare, and I think that it’s important to recognize the terrible psychological consequences of it.

Hospitals in the United States are already beginning to see a great many cases of PTSD from the current conflicts in Iraq and Afghanistan. We know that there are some predictors of who will suffer from PTSD, but that given enough trauma, it can likely happen to anyone.

People Dangerous to Your Health

I found a terrific blog with the title “Warning: Bores and buffoons may endanger your health.”

Our ability to self-regulate is a limited resource that fluctuates markedly, depending on our prior use of willpower, tiredness, stress and our personal resilience.

A new study by a team lead by Professor Eli Finkel of Northwestern University has shown that poor social coordination impairs self-regulation. What does this mean? If you are forced to work or interact with difficult individuals you may be left mentally exhausted and far less able to do anything useful for a significant period of time. In other words, draining social dynamics, in which an individual is trying so hard to regulate his or her behavior, can impair success on subsequent unrelated tasks.

In the research, volunteers were asked to work in pairs to maneuver an icon around a computer maze, with one volunteer giving the instructions, the other moving the joystick. Those operating the joysticks were actors, primed to respond to instructions in slow, stupid, inefficient and generally irritating ways. What was interesting was that the effects were not mediated through participants’ conscious processes: they were almost entirely going on below the level of conscious awareness.

There is extensive literature on the consequences of social conflict. But until now, very little research has been conducted on the effects of ineffective social coordination. That has been a big gap in the research literature, particularly given the fact that most of the higher systems in our brains are dedicated to social functions, and since the earliest days of our hunter-gatherer ancestors, tasks requiring social coordination have been the norm. In our day-to-day activities we have to cooperate with other people. Ineffective social coordination consumes a great deal of mental resources and has high costs for subsequent self-regulation. This is so important, because self-regulation is essential to living life well. It is also essential to the existence of a well functioning society.

What to do with this new information?

Identify people who drain you. If you need to work with them, do it in short bursts, and give yourself plenty of time outs.

And continue to build your resilience.

There’s also one other piece, that we’ll look at another time. Some people may also drain your energy directly. You may have come across "energy" or "psychic vampires." They really do exist, though there is nothing supernatural about them, and they don’t have fangs or an aversion to garlic. In another post I’ll show you some techniques for dealing with those people as well.

The researchers have done us a great service by putting the entire paper on the departmental website. Access is free.

Beating Burnout

I have been getting a number of requests to re-post some of my materials about burnout.

This is a summary of some of the information that we cover in our corporate wellness seminars. For people who are interested, we have also created a Powerpoint slide set, together with reference materials which are available for purchase from our website.

So let us begin at the beginning and ask:

What is Burnout?
This may seem such an obvious question, since the term “burnout” has become part of everyday language, but it is still the topic of a great deal of research.

The best definition of burnout is “a prolonged response to chronic physical, emotional and interpersonal stressors at work.” It is defined by three dimensions:

  1. Exhaustion
  2. Cynicism
  3. Inefficacy

It is more than just an individual experience of stress: it has to be seen in the larger organizational context of people’s relationship with their work.

It is often the case that individuals miss all the signs in themselves.

So what are the main symptoms of burnout?

  1. Worrying, particularly at night
  2. Trouble sleeping
  3. Feeling unappreciated or “used” at work
  4. Feeling less effective or competent than you used to
  5. Easily angry or irritated
  6. Dread of going to work
  7. A feeling of being overwhelmed
  8. Recurrent stress-related physical symptoms like headaches, or back pain
  9. Watching the clock and counting down toward the end of the work day
  10. Rigidly applying riles without considering more creative solutions
  11. Automatically expressing negative attitudes
  12. Finding excuses to be absent from work
  13. Alcohol or substance abuse

We need to ask questions about conditions at work. For instance whether individuals are asked to work extra long shifts, go without breaks and lack clear guidelines.

Who is at greatest risk?
Helping professionals and people who have great responsibility for others, such as  airline pilots and air traffic controllers.

Although there are some psychological predictors for who are more likely to suffer from burnout, with enough stressors just about anyone can become a victim of it. Some people have claimed that burnout is a physical illness resulting from exhaustion of the adrenal glands, but the research doesn’t show that. Burnout is primarily a problem of the system in which you work, interacting with your body and your mind. So now let’s look at how to transform yourself from victim to victor.

The major risk factors are:

  1. Feeling powerless
  2. Being caught in conflict
  3. Having inadequate information
  4. Lack of central visions
  5. Incoordination of the team
  6. Overload
  7. Boredom
  8. Alienation
  9. Ambiguity
  10. Conflict of values


What are the Solutions?

Dealing with burnout needs the help of all workers and the organization as a whole. Sometimes it also needs the help of an outsider. I was once working in a very unhappy place, in the days long before I realized that I had the power to change things myself. A psychologist friend working in the then new field of systems theory, told me that the problem was not with individuals, but that the whole system was “sick” and disorganized and what was needed was a system overhaul.

The opposite of job burnout is job engagement. If you feel that you are engaged in doing something valuable, for which you are appreciated, you are far more likely to have a satisfying life and enjoy doing your job well. There is good evidence that participation, engagement and autonomy are powerful predictors of health outcomes.

First, at the personal level:

The keys to preventing burnout are represented by the acronym REAP:

Resilience
Engagement
Autonomy
Participation

  1. Evaluate your personal goals and priorities: what do you really want to get out of life, and even more importantly, what do you want to put in to life
  2. Ensure that you have established your own core values, your purpose and your meaning. (My book and CD series Healing, Meaning and Purpose spends a lot of time on helping you do exactly that.)
  3. Attend to your own health, through exercise, nutrition and sleep. (I have worked with countless individuals with burnout, whose problems largely evaporated once they were diverted from the coffee, soda and snack machines. Remember the close relationships between food and mood.)
  4. Make sure that you have some outside interests. Not just things that further drain your energy, but something that you enjoy.
  5. Learn some specific stress reduction techniques. (I also have some suggestions for doing so in my book.)
  6. Are you a micromanager who has to do everything yourself? If so, then it is a really good idea to learn to delegate. And don’t take on responsibilities that are not yours. (It took me years to learn that one: I was such a slave to perfectionism, that I always thought that I had to everything myself. Bad mistake)
  7. If your find yourself expressing negativity, work on substituting a positive word for every negative one.
  8. Learn to forgive yourself if things are not going well, and use reversals as the fuel to power you to achievement: it’s what I call “silver-lining:” How to find the positive in any negative situation.
  9. Try to form a support group or see if you can arrange for an outsider to some in and help you.
  10. Are there some specific skills that you need to build and develop?
  11. Can you tailor or change your job?
  12. Develop detachment

Second, at the organizational level:

  1. Evaluate overall work performance: if it declining, it may be an early sign that staff members are being afflicted by burnout.
  2. Consider changes in managerial practices, to move away from the dominator to a partnership model.
  3. Research has indicated that there are six key areas in which mismatches may lead to burnout: workload; personal control; appropriateness of rewards; sense of connection; sense of fairness and a conflict of values. So it is a good idea to break down any analyses and interventions along these lines.
  4. All the evidence suggests that a combination of managerial change and education are the best way to head off and to deal with burnout.
  5. There is also some research showing that a values-based spiritual program to prevent and deal with burnout. The recommendations include a short time for silence, visualization, reflection, active listening, appreciation creativity and playfulness.

What is very clear is that burnout is not just a personal problem; it is something that can affect an entire organization, and has to be tackled as an organization. If it is not, then in these difficult times in health care, we are going to have ever more tired and disillusioned people trying to care for sicker and sicker patients, and just not having the resources to do so.

Transcending Overload and Burnout
There is an important notion that is rarely even talked about. Why does stress and burnout exist? Is it simply bad overloaded wiring in the brain and bad overloaded wiring in our relationships and in our places of work? Well, yes, that is of course correct. But there is also something else: burnout occurs because multiple sets of systems are failing. Nature abhors a vacuum, so from the ashes of these failed systems a new and improved you can emerge. Remember the ancient story of the Phoenix that emerges from the flames. And you might know the statement by Richard Bach: “What the caterpillar calls the end of the world, the master calls a butterfly.”

We need to discard broken systems so that our true self can emerge.

I would like you to think about burnout as a state of consciousness that you are ready to outgrow. You can practice the psychological band-aids, or you can accept the invitation to grow.

There will inevitably be some transition pains, but that is to be expected as the new you is being born. This is also a good time to do an exercise that I recommend in Healing, Meaning and Purpose, and it is to establish where each part of you – Physical, Psychological, Social, Subtle and Spiritual – lies in terms of the Memes of Spiral Dynamics. If you do this exercise every few months, and at times of transition, it can provide powerful proof that the burnout is actually presenting you with a unique opportunity to grow.

Stress, Depression and Resilience

“Patience in calamity, mercy in greatness, fortitude in adversity; these are the self-attained perfections of great saints.”
–The Hitopodesa (Sanskrit fable from the Panchatantra, the “Five Chapters,” Translated as the “Good Advice” c.1100 A.D.)

We are all different in the way that we respond to emotional and physical stress. It is not enough to focus on one single reason why one person handles it and another does not. I have often made the point that we need to consider the physical, psychological, social, subtle and spiritual contributions to any illness or challenge.

New research is shedding light on the interaction between two of these: genes and environment. A multinational research effort assessed the impact of stressor on mood in 275 pairs of female twins. 170 sets of twins were identical: they have exactly the same genetic makeup.

The research indicates that only 12% of individual differences in reactions to stress can be attributed to genetic influences. This is stunning, and should have been reported far more widely: 88% of the differences in the way a person reacts to stress are not genetic, but personal and environmental. This is of great importance in problems such as depression. If genetic factors play such a small role, then paying attention to the development of personal resilience – as well as dealing with social factors – is more likely to be effective than anything else. And, as has been discussed elsewhere one of the ways in which some medicines help people with depression, bipolar disorder and schizophrenia is probably by increasing their resilience.

I have already started showing you some of the techniques for improving psychological resilience and in a future publication we are also going to start work on physical, subtle and spiritual resilience and how to develop more resilient and dynamic relationships.

“Never allow anyone to rain on your parade and thus cast a pall of gloom and defeat on the entire day. Remember that no talent, no self-denial, no brains, no character, are required to set up in the faultfinding business. Nothing external can have any power over you unless you permit it. Your time is too precious to be sacrificed in wasted days combating the menial forces of hate, jealously, and envy. Guard your fragile life carefully. Only God can shape a flower, but any foolish child can pull it to pieces.”
–Og Mandino (American Motivational Speaker and Author, 1923-1996)

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Temporomandibular Joint Dysfunction

The temporomandibular joint (TMJ) is the hinge joint that connects your mandible or lower jaw to the temporal bone at the side of the skull.

The joint can be affected by many disease processes including osteoarthritis, rheumatoid arthritis, the arthritis associated with psoriasis and infectious arthritis. There’s a whole ragbag of other illnesses and injuries that can affect the joint. But it is more commonly affected by muscular tension, problems with the bite, or tooth grinding (bruxism). I’ve been interested in TMJ problems ever since my days working in the Princess Margaret Migraine Clinic in London, where I saw a great many people with chronic headaches due to problems at the joint. A dental colleague helped many of them. Once I had been trained in acupuncture, I found that this is one condition in which I’ve always had good rates of success, both in humans and in horses.

So I was pleased to see an audit of 60 patients with TMJ dysfunction was compiled from the practices of 15 dental practitioners in the United Kingdom who were applying to become members of the thriving British Dental Acupuncture Society. Simple acupuncture was used at local points around the joint, on the neck, and on a point on the hand that is linked up with the joint, and tends to relax muscles and improve blood flow. This was a simple study, and in hindsight, it could have been improved. But the conclusions were encouraging: 85% of patients benefited, and the intensity of the pain was reduced by an average of 75%. This is remarkable since the patients were only receiving acupuncture and not any of the “extras” that I normally recommend as a matter of course.

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Revisiting Resilience

“I don’t measure a man’s success by how high he climbs, but how high he bounces when he hits bottom.”
–General George S. Patton (American General, 1885-1945)

Resilience is the process of being able to adapt and to thrive in the face of adversity, stress, trauma, tragedy or threats. A resilient person is les likely to succumb to any of these life events and is less likely to develop mental illness. But resilience is more than a passive strength or resistance to the slings and arrows of outrageous fortune: it is a dynamic capacity that not only protects us, but enables us to turn adversity into strength and an opportunity for growth.

Despite our extraordinary health care system and a multi-billion dollar antidepressant industry, the rates of depression are increasing throughout the Western world. A recent book has suggested that boredom was unknown before about 1760: the beginning of the Industrial Revolution. All this tells us that something is seriously wrong with our resilience.

“The measure of a man is the way he bears up under misfortune.”

–Plutarch (Greek Biographer and Priest to the Oracle at Delphi, A.D. 46-c.120)

In Healing, Meaning and Purpose, I pointed out some of the incredible changes that have taken place over the last one hundred years, and their impact on health. To try and apply the principles of the past to the problems of the present and future is unlikely to be crowned with success. We need to adapt. Buddhists do not normally eat meat. Except for Tibetan Buddhists, who need to eat some meat in order to survive at the high altitudes of the Himalayas. I have a good friend who created the finest integrated medicine clinic in the world, the Hale Clinic in London. Normally an abstemious vegetarian, when she was embroiled in business meetings, she would often take some meat to remain grounded. I have done the same thing myself for years. I prefer not to eat meat. I have not had a steak in more than thirty years. But if I am to do a lot of traveling and need to work with politicians and business people, a bit of chopped up fish or poultry can be essential.

The changes in our lifestyles over the past century have dramatically reduced the level of physical activity necessary to provide life’s basic resources: our effort-based rewards that are intimately involved in the regulation of mood. If you think about it for a moment, if your great-grandparents wanted to eat, there was probably a lot of effort involved. Our brains still contain a huge number of circuits that evolved to play roles in sustaining the kind of continuous effort that would be critical for the acquisition of resources such as food, water and shelter. So what happens when we suddenly on longer need much physical activity to obtain those resources? What happens to those parts of the brain that have millions of years evolving? There will be reduced activation of those brain regions essential for reward, pleasure, salience, motivation, problem-solving, and effective coping strategies. The practical consequence of that is that these systems will not sit there idling: if under-stimulated, since these systems are so heavily involved with our emotions, we would expect to see people becoming depressed. And we know that depression has been increasing throughout the Western world. Of course, many people need to stimulate these regions of the brain artificially, as with drugs, pornography or extreme sports.

Effort-based rewards are an essential component of resilience to life’s stressful challenges. Purposeful physical activity is important in the maintenance of mental health. It therefore makes sense to put more emphasis on preventative behavioral and cognitive life strategies, rather than relying solely on psychopharmacological strategies. Our strategy is geared toward protecting people from developing depression, and compensatory behaviors. One of the very interesting new ideas in pharmacology is that antidepressants and antipsychotics may act to enhance resilience at both the cellular level and in the whole person. This is a very different concept from thinking of medicines as chemicals that simply block symptoms.

Our aim is to improve resilience and gradually to increase activation of all those under-used systems of the brain to treat and then to prevent problems. All the things that mother always said were good for you: healthy exercise, meditation, a balanced diet, charity and kindness, and actions aimed at fulfilling your personal and Higher Purpose have already been shown to treat and to protect.

Here are some proven methods for improving resilience:
1.    Learn to be adaptable: the heart of resilience is the ability to take things in your stride and to be able to surf the ocean of change, rather than trying to hold the hold it back.

2.    Be aware of the blockages in your mind or in the subtle systems of your body that are preventing you from bouncing back form adversity

3.    Attitude: avoid seeing a challenge as an insurmountable problem

4.    Accept that change is part of life: you can do little about it, but you can do a great deal about how you react to change

5.    Ensure that you have meaningful goals that are consistent with your core desires and beliefs, and that you are moving toward them

6.    Do all that you can to work on establishing your own Purpose in life. You can create a purpose for your life, but also be aware that there is a Higher Purpose in you life

7.    Take decisive actions: even if the first action may not be the best one. Any action is usually better than denying that problems exist, and hoping that they will evaporate while you are asleep or watching television

8.    Develop and maintain close relationships. Even if you are not a sociable person, relationships are one of the most potent way of protecting yourself from life’s ups and downs

9.    Look for opportunities to learn more about yourself, and how you react to situations. This doesn’t mean becoming an introvert or a rampant narcissist, but it does mean taking a moment each day to review where you are and what you can learn form things that are or have happened in your life. This is a big subject, but there are many good ways to answer the question, “Why is this happening to me  again?” and from preventing habitual problems and routine self-sabotage. (I shall be publishing an eBook and CD about this crucial topic in the very near future)

10.  Work on developing a positive self-image. I have had some harsh things to say about the excesses of the self-esteem movement, but it has now been replaced by something far more valuable: the science of positive psychology. We have a great deal of empirical data on how to improve a person’s happiness and resilience. Again, we can speak about that some more if you are interested.

11.  Maintain hope for the future. We have done research that has shown that one of the best ways of predicting a positive outcome with major mental illness, or of reducing the risk of recurrent substance abuse is to instill hope. Again, there are techniques for doing this, even when the whole world seems to be against you.

12.  Maintain perspective: do not blow things out of proportion, and remember that this too shall pass.

13.  Take care of yourself, physical, emotionally and spiritually. Listen to yourself: what does your body need? What do you need emotionally? What do you need from a relationship? What do you need spiritually?

14.  Are you giving others what they need from you? If you have a nagging sense that you are not giving a child or a spouse that they need and deserve, it can dramatically reduce you resilience.

15.  Rather than just thinking about and worrying over your problems, or problems that may turn up in the future, get into the habit of thinking of yourself not just as an individual who is going through problems, but as a boundless spiritual being who is learning a lesson.

16.  Never forget to think about the legacy that you are going to leave. Not just to your family, but to the world at large. If you can’t think of one, this is a good time to begin to create one. That is an enormously  powerful perspective on the world and on your problems.

“I am an old man and have had many troubles, most of which never happened.”
–Mark Twain (a.k.a. Samuel Langhorne Clemens, American Humorist, Writer and Lecturer, 1835-1910)

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Sick Building Syndrome

Sick building syndrome (SBS) was first recognized in 1982, and is a combination of symptoms associated with an individual’s place of work – most often an office building -though there have also been instances of SBS in residential buildings. A 1984 World Health Organization report into the syndrome suggested up to 30% of new and remodeled buildings around the world might be linked to symptoms of SBS.

Many symptoms have been associated with SBS, including:

  • Headache
  • Dry or itchy skin
  • Chronic fatigue
  • Irritation of the eyes nose or throat, sometimes with a dry coughs
  • Dizziness
  • Nausea
  • Difficulties in memory and concentration
  • Extreme sensitivity to smells or bright lights

For SBS to exist, these symptoms must disappear soon after the occupants go outside.

There have been many explanations for these symptoms, primarily related to environmental pollutants. But I have something to add to that list. Some time ago I spent a happy year working at the Charing Cross Hospital in London during which I made an odd observation. On days that I worked in the laboratory on the tenth floor, I would be exhausted by the middle of the day, while on days when I worked in the outpatient clinic in the basement, I could easily get through a 5 hour clinic without difficulty. I mentioned it to a neurophysiologist friend who told me something very interesting: it had been discovered that on days when the wind blew at 5-10 miles an hour, the building began to vibrate like a giant tuning fork, and that the vibration was at its worst between the tenth floor and the top of the hospital. The vibration was imperceptible to most people, but I clearly had the misfortune to be sensitive to it. Yet without this experience, I might never have known of the potential adverse effects of vibration of the human body.

I have been consulted by a number of corporations and government organizations that have had trouble with people getting sick in certain buildings. Until now we have thought that it was all environmental, and that it could be anything from vibration to poor ventilation, chemicals, molds and many things in between. So I was very surprised to see a report published in the journal Occupational and Environmental Medicine from a first rate research group at University College London.

The British Inland Revenue Service demolished an entire 19-storey building in Bootle, Merseyside, after almost half of the employees had developed illnesses compatible with SBS. In a study published two and a half years ago, it was claimed that adding ultraviolet light to ventilation systems to kill microbes could vanquish the symptoms of SBS. But this new research suggests that the cure may actually be better management.

The new study included 4,052 civil service workers between the ages of 42 and 62 who were enrolled in a larger general health study. The men and women in the study worked at 44 different office buildings around London. The workers completed surveys designed to assess their general health and whether they had symptoms linked to SBS. They were also asked questions about the physical properties of the offices that they worked in and the stresses associated with their jobs.

As in earlier studies, women tended to have more symptoms associated with SBS than did men. Younger workers also had more of the symptoms than older workers. Almost one in five women and one in seven men reported five or more symptoms associated with sick building syndrome.

Now here was the surprise: the authors found little association between physical work environment and the symptoms. But there was a strong association between the symptoms and feelings of having high job demands and little support in the workplace. They also found that the more control people have over their workstation, the fewer symptoms were reported.

Though the findings fail to support "sick buildings" as a common cause of worker illness, the study should not be interpreted as meaning that the physical quality of the workplace is unimportant. It is most likely that we are dealing with a combination of physical and work related factors.

As I was reading the report and reviewing the rather vague but often quite severe symptoms, I was reminded of some recent work that I have been doing on burnout: I’ve just published an article about it. My interpretation of this study is that many cases of SBS are likely a form of burnout that is partially modulated by physical factors in the environment.

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Using your Core Values for Rapid Stress Management

“The cyclone derives its powers from a calm center. So does a person.” — Norman Vincent Peale (American Cleric, Writer and Self-Help Expert, 1898-1993)

As a professional speaker, I often forget that glossophobia – fear of public speaking – is the most common phobia in America today. I have a whole toolkit of techniques that I use for helping people with this problem, but I am always interested in new methods that can work quickly.

A study of 80 UCLA undergraduates published in the journal Psychological Science suggests that taking a few minutes to contemplate your personal values (Click here to take an online assessment of your personal values) in the moments before a tense situation, like making a speech, an examination or a visit to the dentist, can keep stress levels low.

People in the study who affirmed their values before delivering a speech had significantly lower levels of one of the stress hormones – cortisol – than did the control group, and psychological measures also indicated that they were less stressed.

“People can’t live with change if there’s not a changeless core inside them. The key to the ability to change is a changeless sense of who you are, what you are about and what you value.” –Steven R. Covey (American Author and Businessman, 1932-)

Reaffirming your core values is one of the keys to the development of resilience, and that is what was happening in this study. For anyone who is interested in dealing with fear of public speaking or in developing personal resilience, we shall be putting new articles on my website in the next few days.

“Remain calm, serene, always in command of yourself. You will then find out how easy it is to get along.” –Paramahansa Yogananda (Indian Spiritual Teacher and, in 1920, Founder of the Self-Realization Fellowship, 1893-1952)

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Partial Attention

“To do two things at once – is to do neither.” — Publilius Syrus (Syrian-born Latin Writer, 1st Century B.C.E.)

Just yesterday I was counseling a successful young businesswoman who was telling me that she was planning to buy a Blackberry to add to her cell phone, laptop, PDA and pager. I strongly advised her not to buy one. Not because I have anything against Blackberries: they are wonderful pieces of equipment, and some people cannot do their jobs without them. My suggestion was based on something else entirely: Overload. Apart from being in business, she is also a mother of a young teething child and the last thing that she needs is yet another device to occupy her attention.

So I was delighted by the remarkable coincidence that this week’s Newsweek magazine is carrying an important article by Steven Levy, reporting on the recent emerging Technology Conference in San Diego that took "The Attention Economy" as its theme. He described an issue that has been worrying me for several years and which I shall be addressing when I am interviewed for Success.com in a couple of weeks time. A former Apple and Microsoft executive named Linda Stone described the epidemic of continuous partial attention.

We have all been multitasking since before our ancestors came down from the trees, but she discussed the way in which people’s attention is now constantly being distracted by a host of new inputs: email, text messaging, instant messaging and a hundred other things. And think of those news broadcasts that since 2001 have regularly had more than one item at a time on the screen. Many people have learned to give only partial attention to the task before them. The downside of this is that the appearance of competent multitasking (“Look mom, I can do ten things at once!”) is an illusion. If you are only working on a project with 10% of your attention, it is going to take much longer to get it done, and errors are far more likely to occur. What if needed is intense focus on one thing at a time.

In a speech, Linda Stone said that I prominent cause of continuous partial attention is "a desire to live as a node on the network." Some people can manage several inputs very well indeed. I often have more than one screen of input open at once, and Bill Gates is able to monitor four active screens at once. But when I’m really concentrating on producing high quality material for you, gentle reader, I turn off all the inputs until I am finished. In fact, checking my email is a reward for having finished the job at hand. While there are many advantages to being in perpetual contact, the balance has tipped more toward distraction, and, as Linda Stone put it, “a sense of constant crisis.”

I am also reminded of the phenomenon of “Flow” made popular by the psychologist Mihaly Csikszentmihalyi. We feel that we are in a state of flow state when we are engaged in self-determined, goal-related, meaningful actions that are moving in the direction that we desire. Having our attention and energy pulled away from the flow is likely to interfere without ability not just to be productive, but also to enjoy life. There is, of course nothing wrong at all with being in continuous contact and communication with others people. But in order to be productive or to enjoy the moment, at some point you need to actually stop the conversation and focus on what you are doing.

Professor David Meyer from the University of Michigan at Ann Arbor is a research psychologist who has demonstrated that multitasking, far from increasing our productivity, actually makes us less productive. Some data from Europe has influenced lawmakers, after research indicated that driving and talking on a cell phone is a particularly bad multitasking combination that has been shown to cause even more accidents than drunk drivimg.

Remember the old saying: “If you chase two rabbits, both will escape.”

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Hunger and Memory

It’s always a good idea to see how new findings fit in with previous knowledge, and also to see if they make sense. We have previously met the hormone leptin, which is involved in decreasing appetite. Its twin is the hormone ghrelin. Discovered in 1999, ghrelin comes from some of the cells lining the stomach and acts in the hypothalamus to increase appetite. When the stomach is empty it is released into the circulation and travels to the brain where it activates receptors in many different regions. Some research has indicated that one of the reasons why gastric bypass surgery may be effective is because it reduces levels of ghrelin and therefore reduces appetite.

Research published in December 2004 showed that in healthy young men, sleep deprivation caused a decrease in leptin levels and an increase in ghrelin levels, which, as expected, was associated with an increase in hunger and appetite. This is one reason why getting less sleep than you need may cause you to gain weight.

A new study published in the journal Nature Neuroscience, has found an intriguing link between ghrelin and memory. I noticed that the BBC also picked up on this interesting story. Researchers at Yale have discovered that ghrelin acts in an ancient part of the brain known as the hippocampus: so named because it is shaped like a sea-horse. (As an amusing aside, the old German pathologists thought it looked like a silk worm, so that’s what they called it!) The hippocampus has a number of functions, but is most of all essential for learning new material.

The researchers showed that mice who lack the ghrelin gene had 25% fewer synaptic connections between their hippocampal neurons. They then did the next step, and injected normal mice with ghrelin. They promptly increased the number and density of their synaptic connections, which correlated with significant improvements in the animals’ performance on several tests of learning and memory.

So that means that a hormone produced by the stomach can control some brain functions, and this may represent a link between metabolism and the ability to learn. The more that we discover, the more we see the intimate interactions between the brain, intestines and heart.

This link makes good sense: we know that memory can be switched on and off by a range of factors. In order to help us come up with options for handling the environment and for remembering things to avoid, memory is often switched on at times of stress. Hunger is a form of stress, and it makes good biological sense that we might be more alert and better able to remember and to recall information when hungry. It stands to reason that this has enormous survival advantage. If our early ancestors had not had this hunger/memory link, they might well have died out in the competition for food.

This gives some credence to the old advice that it is best not to try to study or to take an exam on a full stomach. Just have enough food to make sure that you have ample fuel, and that you are not distracted by hunger pains.

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