The Uses of Distraction

Image via WikipediaThe Uses of Distraction: I have held a question in my mind for some time about the usefulness (or not) of distraction techniques for people who are prone to anxiety, depression, impulsivity, and so forth. In my clinical practice, I use mindfulness-based methods, and teach folks to "stay with" the chosen focus point, even if or when it is not pleasurable. This has been a mainstay of meditation teaching for centuries: for example, when you are sitting meditation, with a primary focus on the breath, you inevitably will encounter other mental phenomena. Two very common ones are: an itch appears on your head; and you have an impulse to get up off the cushion and do something else. The meditation teacher will tell you that it is helpful to shift your focus directly to the nagging, intrusive phenomenon. You can direct your attention, your mental focus, onto the sensation of itching, onto the feelings and thoughts that comprise the impulse. Examine them with curiosity and compassion. In doing so, you will learn that these phenomena are not nearly as compelling as they first seem; you will learn that they shift and change, they are transitory (itches and impulses go away on their own, if you do not give in to them). These are important things to learn, important skills for your mind/brain to practice.

But it is also possible, when encountering an unpleasant mental phenomenon, to engage in deliberate distraction methods (shifting attention away from the unpleasant feeling, to something else). Marsha Linehan, a very prominent psychologist who developed a mindfulness-based treatment method called Dialectical Behavior Therapy, includes distraction methods within the sets of skills that she teaches. As a psychologist and psychotherapist, I have always been a bit uneasy about this, because it seems so similar to the avoidance patterns that patients (especially those with anxiety disorders) usually use, as a default method, to escape from unpleasant thoughts and feelings. And avoidance is generally a poor strategy. Mindfulness is considered an antidote to avoidance (see: Acceptance and Commitment Therapy). Dr. Linehan (her picture is at the upper right of this post) has said that the patients she works with (those with Borderline Personality Disorder) are simply too fragile and impulsive to tolerate extended exposure to unpleasant thoughts, emotions, and feelings. She believes it is important to teach them ways to safely and effectively shift their attention to a focus point that will give them some relief and short-circuit their typical (usually self-destructive) escape strategies.

I am coming around to the belief that both mindful attention toward, and also mindful attention away from, unpleasant thoughts, feelings, impulses, etc. can be of benefit and can contribute to effective emotion regulation. A point someone made in a recent discussion (sorry I can't recall who said it... it was in the Chicago Study Group) was that, in order to deliberately shift your attention away from something, you must first have become aware of, or conscious of, whatever it is that is troubling you. And, accordingly, you will have arrived at a conscious "choice point" as to where to place your attention, in the present moment. This is different from the mostly non-conscious, and highly reactive, avoidance strategies that are typically used by people who suffer a lot from anxiety and mood disorders.

As for me, at this time in a life that is overly filled with difficult thoughts and emotions, I find that mystery novels are a great distraction method. I recommend April Smith, Susan Hill, and Denise Mina. And James Lee Burke.

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