Focus

by Allen Weiss, MD, MBA, FACP, FACR
President and CEO, NCH Healthcare System

Paying attention matters. Willpower matters. Feedback matters. All three can save your life or at least improve your life, according to psychologist Daniel Goleman in his most recent book, Focus: The Hidden Driver of Excellence.

People who excel and are nimble in focusing their attention thrive. Those who are “out to lunch” or inattentive to their own feelings or surroundings typically do not do as well as those who are in touch with their environment.

Smart practices such as mindfulness meditation, focused preparation, recovery from setbacks, continued attention to the learning curve, and positive emotions and connections add new skills, develop good habits and are able to sustain excellence.

All of these good habits are like muscles which strengthen when used. When not used, these habits wither away. Using the term “clueless” is shorthand slang for someone who is not in touch with either themselves or the world around them.

Paying attention to ourselves (inner focus) attunes us to how we think, our personality, our values, and how we make decisions.
Many people believe early childhood from birth to preschool is the time of greatest development for this inner awareness. A classic experiment involving marshmallows was performed in the 1970s at Stanford University by psychologist Walter Mischel. It makes the point about the importance of the early years.

Preschool 4-year-olds were invited into a room one by one by a friendly preschool teacher. The room had no distractions. The child was asked to sit down at a small table with a tray containing one marshmallow. The teacher then said, “You can have your treat now, if you want. But if you don’t eat it until I come back from running an errand, you can have two then.”

The children were observed though a one-way mirror. About a third grabbed the marshmallow on the spot, while another third or so waited the endless 15 minutes until they were rewarded with two.

The others fell somewhere in-between. Mischel observed that some would “cover their eyes with their hands or turn around so  that they can’t see the tray, others start kicking the desk, or tug on their pigtails, or stroke the marshmallow as if it were a tiny  stuffed animal,” while others would simply eat the marshmallow as soon as the teacher left.

Willpower is a form of focusing. The ability to wait 15 minutes turned out to be an excellent predictor of success in later life. Ten  years later, the two marshmallow kids were reported to be more competent and did have higher SAT scores. A 2011 brain imaging  study of a sample from the original Stanford participants when they reached mid-life showed key differences between those with
high delay times and those with low delay times in two areas: the prefrontal cortex (more active in high delayers) and the ventral  striatum (an area linked to addictions) when they were trying to control their responses to alluring temptations, according to a  Proceedings of National Academy of Sciences paper 40 years later.

An outer focus lets us navigate in the environment around us. This is not just the physical setting; it also means connecting empathetically with those around us. Helen Keller was asked which was worse—loss of vision or hearing. She said hearing loss  was worse as this handicap separates you from people, whereas blindness separates only from things.

Self-confidence also matters in terms of success. Here is just one of many inspirational stories of folks who stuck it out and eventually succeeded. It’s the true story of a near high school dropout who also was involved in a near fatal car accident just before high school graduation. This science fiction buff went to a local community college as he was recovering from the auto trauma and developed an interest in film making. His college film project caught the eye of a Hollywood director who hired him as an assistant.

Moving up in his career, this creative and self-assured young man learned the bitter lesson that his creative talents would be  subjugated to the financial interests of the studio bosses who had ultimate creative control. But he believed in himself. He put all  his money into his own creative film to avoid interference from the studios, and realized his dream.

Star Wars was released by George Lucas with incredible success. He had the self-confidence and didn’t get intimidated or  distracted by others.

Paying attention to feedback is also critical to success. Psychologist Daniel Kahneman, in his best-selling book Thinking Fast and Slow, relates two examples of not believing the evidence when the culture of your industry is under attack.

Kahneman was given a treasure trove of eight years of financial performance information from an investment firm which advises very wealthy people. The advisors were rewarded with big bonuses at the end of the year based on performance.

Shockingly, the analysis of the data showed none of the advisors was consistently any better than chance in managing the money  of wealthy clients. Obviously an upsetting conclusion if accepted by either the advisors or their clients. Nonetheless, nothing changed and life continued. It is just so hard to accept analysis which is not congruent with what you have believed in and have been accustomed to doing. It is embarrassing to admit that you give or receive “voodoo” financial advice.

The subprime derivative meltdown—which was largely responsible for the most recent recession—comes to mind as another example of group think and lack of feedback. Group think and avarice are the causes for otherwise smart people buying collections of mortgages which ranged from the best of the worst to the worst of the worst. When asked by one of the originators of the scheme as to who would buy these instruments, his reply was: “Idiots.”

Paying attention, willpower, and feedback are all three attributes necessary for success of any individual or organization.

The good news is they can be developed with practice and discipline. It is never too late to improve our focus.