02/24/2014 – Attention Excess Disorder

Are you working endlessly but not accomplishing all that you want? Mystified that continuous attention to work tasks is not resulting in satisfactory progress toward your strategic goals? Distracted to the point that you’re not thinking, planning, or executing as well as you can?

Sounds like you might have attention deficit disorder (ADD), a diagnosis that countless millions of Americans will receive this year. Many of them will go on to take potentially toxic medications like Adderall, which might help with mental focus but also cause insomnia, agitation, drug dependency, and other adverse effects.

Now consider the possibility that we’ve got this all wrong. The “attention deficit” construct is driven largely by big Pharma interests and a compliant medical/psychiatric profession, whose interests also are served by lots of prescribing. The research on whether ADD deserves scientific status as a formal medical/psychiatric disorder is questionable. A major New York Times article in December 2013 explored the problem and the interests driving it.

My experience as an executive coach and psychiatrist has taught me how essential it is to question the received wisdom about ADD. In many (if not most) cases, I end up guiding my clients to call the “ADD” paradigm into question. The world is topsy-turvy in this area — and what appears to be “attention deficit” often turns out to be “attention excess.” An alternative paradigm addresses the attention difficulties in over two-thirds of the professionals and businesses leaders I see in my practice.

The syndrome, which I call “Attention Excess Disorder” (AED), captures the trend toward poor self-management that so many stressed out and overworked leaders experience. Much is written about ADD, but little heed is paid to its potentially more damaging counterpart. The AED construct reminds us that an individual may be perfectly capable of paying attention, but is misdirecting his or efforts — and paying excessive attention to the wrong things.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), ADD is diagnosed when an individual meets 6 of 9 criteria of inattentiveness. Analogously, AED is identified by observing at least 6 of 9 behavioral patterns in a client for 3 consecutive months. Adopting the language of DSM, the syndrome causes “social and occupational dysfunction.” In other words, excessive attention to narrow work tasks causes damage to social relationships and failure to thrive at work.

Here are the criteria: the client with AED….

1) works at least 70 hours per week, or at least 6 full days (10+ hours) per week on average.

2) checks email, LinkedIn, Twitter, or other social media at least 10 times daily on average.

3) persistently avoids lunch breaks, naps, aimless walks, or other “down time” activities.

4) suffers chronic sleep deprivation, i.e. less than 7 hours per night of sleep on average (or at least 2 nights per month with less than 4 hours of sleep).

5) fails to delegate tasks that are more appropriate for employees, direct reports, or other colleagues.

6) spends at least one-third of work day multitasking rather than attending to a single task in depth.

7) neglects essential parts of life outside work, such as hobbies, exercise, friendships, volunteer work, cultural activities, or reading for pleasure.

8) fails to take a non-working vacation of a week or longer within each calendar year.

9) takes stimulant medication for attention deficit disorder (ADD) even if it causes adverse effects such as insomnia, anxiety, or drug dependency.

The AED paradigm incorporates important findings from current neuroscience. A growing body of research shows that optimal brain functioning depends on adequate “down time” and sleep.  A recent article in Scientific American entitled “Why Your Brain Needs More Downtime” compellingly summarizes the evidence that “mental breaks increase productivity, replenish attention, solidify memories, and encourage creativity” .

This article cites research by Harvard Business School researchers who conducted a 4-year study of the effects of scheduled down time on workers at Boston Consulting Group. The results included higher work productivity and increased capacity to envision a long-term career with the firm. The article also cites a Stanford study that showed that physicians and nurses who took naps during long overnight shifts outperformed colleagues who didn’t nap on measures of attention, a simulated medical procedure (inserting a catheter), and a simulation of driving a car home.

Other research shows that that mind wandering, rather than being a symptom of a disorder like ADD, may actually be a prerequisite for creativity, entrepreneurship, and visionary leadership. Meditation and other “mindfulness” techniques may have similar benefits. There is also growing research and media attention to the fact that good sleep is essential to adequate brain functioning. Since so many overworked professionals and executives don’t get good sleep on a regular basis, their attention difficulties may result from inability to “unplug” from work and restore their brains’ capacity to function optimally.

Cutting-edge research suggests that there are immeasurable opportunity costs to a continuous laser focus on work. Excessive attention to narrowly focused work tasks and chronic multitasking can preclude the development of an original idea, the implementation of that idea, or the conversations that can foster new partnerships, creative goals, and innovative strategies to achieve them.

A major risk to our having adequate “down time” is social media and other Internet technologies. In The Shallows, Nicholas Carr describes how careless use of these technologies may impair our ability to think deeply and perform critical intellectual tasks. Excessive attention to our smartphones and tablets also can interfere with the social engagement and connectedness that can foster creative human-to-human collaboration. Carr’s incisive commentary, rooted in emerging neuroscience and related research, supports the AED paradigm and the solutions to managing it.

The AED framework provides practical guidance in executive coaching. Here is a case from my own practice. The CEO of a large and successful family business came to me with a complaint that he couldn’t mentally focus at work, where he frittered away 20-30 hours per week of potentially productive time. He “surfed” the Internet and multitasked with multiple windows open on his computer throughout the day, rather than engage in deep, meaningful work. He was inputting employees’ 401(k) payments into an outdated computer system each month, rather than delegating this and other non-CEO tasks. His sleep schedule was unregulated and he had stopped exercising. He was obsessed with the company’s challenges and his perceived inability to lead the company effectively toward stability and growth.

My impression was that he didn’t have ADD, but rather AED – and we agreed to address his situation on this basis, rather than turn to medications for ADD. With intensive coaching over the coming months, he established a healthy sleep schedule and exercise regimen. He scheduled “down time” for himself (including a yoga class) and with his family, whom he realized he had neglected for some time. By hiring an executive assistant and delegating non-CEO tasks, he freed up time and energy to have networking breakfasts with potential investors in the company (which he aimed to expand outside the local market). As he began to have more face-to-face discussions with family and colleagues, he realized he was no longer multitasking or spending unfocused, unproductive time on his computer. His work satisfaction, productivity, and leadership capacity have skyrocketed and the benefits – financial, personal, and otherwise – have endured.

“Attention excess” is rampant among high-performing professionals and executives. The AED model prompts us to consider how to focus our efforts and achieve greater mental agility so that we can successfully manage our lives at work and at home. Consider a regular sleep schedule and exercise regimen, a vacation every once in a while, a renewed effort to delegate work, a decision to put your smartphone down for the afternoon. Take a nap, or a walk, or a yoga class.  Read that novel that’s been sitting unopened on your bedside table. Consider paying less attention – not more. Compelling new research in psychology and neuroscience suggests that the results may pleasantly astonish you.