Stolen Focus: Why You Can't Pay Attention--And How to Think Deeply Again

Diagnoses of attention deficiency were very rare during Hari’s childhood, but rapidly increased in the early 2000s. At the time of writing 13% of all adolescents in the US have ADHD, with many being medicated for it. Hari questions why adults with attention issues often look to lifestyle factors to explain their problem, while the same issue in children tends to be interpreted as a “biological disorder” (214).

Hari reveals that this is the most difficult subject he has tackled. ADHD diagnosis is an ongoing controversy within medicine and psychology; many scientists disagree that it is a biological illness. Hari assures readers that ADHD is a “real problem” and not something imagined; he hopes his analysis contributes to a “calm and honest conversation” about the diagnosis (214).

The American Psychiatric Association first recognized ADHD in the late 1960s, calling it a real, but rare, issue for some children. Now, however, doctors increasingly diagnose children and adults with this disorder and the market for prescribed ADHD stimulants is valued at $10 billion. Some experts consider ADHD a biological illness that should be treated with such drugs, while others believe that symptoms should be addressed in other ways.

Psychiatric diagnoses have also surged in animals: dogs, horses, and various zoo animals are now prescribed drugs such as Ritalin and Prozac to manage symptoms of anxiety. Veterinarian Nicholas Dodman, who popularized psychiatric drugs to manage animals’ behaviors, concedes that if these animals were able to fully engage in natural environments and express their inborn instincts they would not need to be medicated—but as it is, drugs help them cope with “reality” (220). Hari strongly disagrees with this approach, since it “takes a dysfunctional environment for granted” (220). Hari wonders whether children are in a similar position: Their environments have also drastically changed over the last few generations, from their diets, to air pollution, and a lack of outdoor free play.

British child psychiatrist Sammi Timimi is highly critical of medicating children for ADHD. Many of his child patients recovered from their ADHD diagnoses once their underlying problems were addressed. For example, children whose attention deficits were caused by stressful events in their families or schools were successfully weaned off prescription drugs and thrived afterwards. Timimi claims that ADHD is not really a diagnosis—a doctor cannot test for concrete evidence, but can only acknowledge the “certain behaviors that sometimes occur together” (224). While Timimi’s stories are anecdotal evidence, a long-term study on the subject led by child development expert Alan Sroufe confirms Timimi’s claims. Beginning in the 1970s, Sroufe followed 200 children born into impoverished families, as they grew from infants into adults. He was curious to understand the factors that shape people’s lives. While the study did not focus on ADHD, Sroufe expected to find neurological predictors in people’s early years. However, the study revealed that the most important factor in predicting ADHD was the level of stress and “chaos” in a child’s environment (225). After decades of research, Sroufe became convinced that no one is genetically destined to develop ADHD. He also observed that social support was very successful in helping both parents and children.

Stimulants such as Ritalin can effectively treat attention issues. However, many doctors are reluctant to prescribe ADHD medication because of the risks and unknown long-term effects. Doctors in the US and Israel prescribe such drugs the most. Two of these drugs, dextroamphetamine and Adderall, have been shown to have similarities with methamphetamine, a highly addictive illegal narcotic. Hari notes that all adults and children, whether they have been diagnosed with ADHD or not, can focus better when taking a stimulant.

Using these drugs puts children at a greater risk of stunted growth and heart problems, and doctors do not yet know their long-term risks for children’s brain development. New York University neuroscientist Xavier Castellanos says that while these stimulants improve kids’ performance on repetition-based tasks, they do not otherwise help children learn. Over time, children’s bodies develop a tolerance for the medication, requiring an increase in dosage. Moreover, stimulants often reduce sleep, which is a crucial part of children’s development. While many US experts believe that it is safe to prescribe ADHD drugs to children, international experts are concerned about this approach.

Over 20 studies on twins have concluded that ADHD is a biological disorder with a genetic basis; however, critics of this work argue that because identical twins are more likely than fraternal twins to spend more time together, share behaviors, and even conflate their identities, these studies cannot reliably prove that these twins’ diagnoses are the result of genetics rather than their environment. SNP Heritability, a study method that compares the genetic makeup of different people to correlate which genes play a role in attention issues has found that genetics accounts for only 20-30% of attention issues. Psychologist Joel Nigg explains that genes only affect the probability of someone having an attention deficit, rather than interpreting genetic makeup as “destiny” (235). Nigg emphasizes that while medication can provide short-term relief, “it’s a bit criminal to say nothing more than, in effect, ‘Let’s placate them with medications so they can cope with this damaging environment we’ve created’” (236).

There has been a dramatic decline in unstructured, unsupervised play. Children in Western cultures spend much more time indoors and have more parental supervision than in previous generations. Activist Lenore Skenazy advocates for children to experience more freedom and independence and to enjoy unstructured play with other children. Growing up in the 1960s, Skenazy often walked around the neighborhood by herself. In the 1990s, Skenazy decided that her son should experience a bit of what she enjoyed growing up, and helped him learn to navigate some of New York City on his own. However, when she wrote about her experience, many people accused Skenazy of parental negligence. Skenazy was bewildered by the fact that society is much safer than it has ever been, yet many parents consider it too dangerous to allow their children to play the way that they once did.

Modern children live under a kind of “house arrest” (245): more time in front of screens, doing homework, and going on errands with their parents. This reduction in freedom and outdoor play has several consequences: lack of exercise, which has been proven to play a role in various aspects of brain health; a reduction in imagination and creativity; diminished social bonds; and less joy and “aliveness” (244), all of which contribute to emotional and brain health. Indeed, primatologist Isabel Benchke believes that play is the “foundation” (244) of personality and attention. Moreover, social psychologist Jonathan Haidt argues that a lack of independent free play leads children to feel incompetent and in need of guidance. In turn, this creates anxiety, which is detrimental to one’s ability to pay attention.

Skenazy emphasizes the connection between free play and investigating one’s interests and motivations. She believes that focus is a learned habit people build in childhood when they are truly engaged in something. When she talked to parents about the benefits of free play for her “Let Grow” campaign, parents fondly remembered their own free play experiences, but very few of them were able to change their parenting style and allow their kids to leave home alone. However, when one school, Roanoke Avenue Elementary, signed up for Skenazy’s program and encouraged parents to allow their children to do activities independently, their students felt empowered.

Children’s lives are also micromanaged in school settings. In Hari’s own typical British education, all classes were prescribed to him and did not include free exploration. His school curriculum felt “meaningless” (259) and he hated school, even though he enjoyed reading on his own at home. In contrast, an alternative Massachusetts school called Sudbury emphasizes unstructured play and inquiry-based learning. Most of its graduates pursue higher education, and children with learning difficulties tend to perform better at Sudbury than their previous schools. Likewise, the Finnish school system is particularly adept at promoting play within the school curriculum; kids are required to play for 15 minutes for every 45 minutes of teaching time. Finnish teachers assign little homework and few tests. Hari attributes the very low rate of attention disorders in Finland to this play-based approach. Hari argues that the younger generation has been set up to fail by the culture around them.

James Williams, a former Google strategist, identifies three kinds of attention, all of which are under threat: “spotlight” attention, which allows people to complete short-term goals like making a coffee; “starlight” attention, which helps people make progress towards long-term goals; and “daylight” attention, which allows people to reflect on the purpose behind their actions and understand their goals’ meanings (268). Hari adds another kind of attention to William’s list: “stadium lights,” in which people work together for collective action on issues (268).

Hari has used six methods to help heal his focus: locking his phone in a timed safe every day, restricting his computer’s ability to access certain sites, not shaming himself when he is distracted, and trying to access a flow state based on what is meaningful to him. He also takes months-long breaks from social media, allows his mind to wander on long walks, and tries to sleep for eight hours a night. Lastly, he allows his godchildren to engage in free play, rather than planned activities. Hari wants to improve his diet and stress levels, but struggles with this aspect of lifestyle change. He believes individuals can and should pursue changes to improve their focus, while also understanding that there are systemic problems they cannot solve alone.

Living through the COVID-19 pandemic has had a devastating effect on many people’s attention spans due to stress and a lack of human connection. This is indicative of what could happen to focus in the future if threats to attention go on unchallenged. Hari makes the following recommendations: banning surveillance capitalism, introducing a four-day workweek, and allowing kids to play more freely at home and school.

To build an effective movement for preserving people’s attention, Hari consults Ben Stewart, the former head of communications for Greenpeace UK. Stewart shares that movements are most successful when they galvanize people around a shared “site battle” (274). For example, Stewart and other activists vandalized a coal plant to raise awareness about the pollution crisis. Hari and Stewart wonder if Twitter and Facebook headquarters could be appropriate sites for the “Attention Rebellion” (277). The movement to reclaim attention is a daunting task, but all human rights movements are considered impossible at the beginning.

Thomas Hylland Eriksen, a Norwegian professor of social anthropology, supplies a final cause of attention issues: economic growth. Eriksen claims that since human cultures tend to define success as constant growth, companies must sell more and consumers must buy or do more in the same amount of time each year. This “need for economic growth seemed to be the underlying force that was driving so many of the causes of poor attention […]—our increasing stress, our swelling work hours, our more invasive technologies, our lack of sleep, our bad diets” (279). Hari instead promotes Jason Hickel’s concept of a “steady-state economy” (279), which would not prioritize growth, but focus more closely on quality of life indicators. Preserving people’s attention is the first step to productively solving imminent problems such as the climate crisis. Hari urges readers to preserve their attention and act collectively for this cause.