Category Archives: General

Neuropsychology and Migraines

I wanted to say a few words about migraines and migraine disorder. Some of my clients and personal connections suffer from this pain. They are not just a headache. They can be a torment for many. Not only are migraines physically painful, they often affect appetite, light and sound sensitivity, mood, balance and coordination, because dizziness and vertigo can happen, fatigue , and anxiety. Causes for migraines can include stress, fluctuations in barometric pressure, hormonal shifts, allergens, dehydration, genetics, and sometimes no reason whatsoever, which is the hardest.

It is well documented that our thoughts, feelings, and beliefs have an enormous impact on our physical well-being. In other words – the mindbody connection is much more powerful than we could have imagined. According to the latest studies, letting go of mental distress can lower your blood pressure, writing about traumatic events can alleviate physical symptoms of chronic pain, and your personal beliefs about stress have a direct impact on your physical health.

Migraines are no exception to this phenomenon. There is clinical evidence that the degree of migraine disability is correlated with our attitudes and feelings about the migraines themselves. Feelings of fear and avoidance play a huge role as well, leading to increased migraine frequency and decreased quality of life for many migraine sufferers. All the while, attempts to find long-term relief through medication can lead to medication overuse.

Regardless of the impact that our emotions have on migraines, this is not a “chosen affliction” – it’s a direct result of the way the brain has wired itself over time. Initial attacks may result from any combination of environmental and genetic factors that cause the nervous system to become particularly sensitive to certain stimuli.

There is substantial evidence that individuals who experience adverse childhood events (such as neglect, emotional abuse, verbal abuse, or sexual abuse) are significantly more likely to develop migraine later in life. This suggests, at minimum, that our genes and nervous systems are stamping in a painful wiring pattern at a very young age. Over time, these patterns become ingrained in the nervous system as migraine attacks slowly rewire the brain to perpetuate this feeling of pain.

The good news? This neurological sensitization to pain can be undone, in whole or in part, through education and exercises that help the brain to let go of past stressors and learn new, less painful neurological patterns. Treatment harnesses the benefits of multiple mind-body approaches that have been proven to reduce migraine frequency and intensity – like meditation, CBT, and mindfulness-based stress reduction
Relief usually requires a multimodal approach.

See also –  Pain Share: On Helping Friends and Family With Chronic Pain Conditions.

Brain/Mind: Forever Lovers

I write for several mental health and psychology journals and blogs. Every month, I field questions that may be relevant to several people and their interests. Recently, I was asked to differentiate between sympathy, empathy, and compassion, and their significance. While there is overlap, the empirical data and clinical experience indicate differences among these concepts.

In addition, I have been exploring the concept of Empath, which is somewhat different, and does not yet have sufficient research. As you know, I believe in the combination of clinical, empirical, cultural competence, and lived experience, so it’s an intriguing area for further study.
*Empathy means that you feel what a person is feeling.
*Sympathy means you can understand what the person is feeling.
*Compassion is the willingness to relieve the suffering of another. It is an active process of wanting to help others.

When you are viscerally feeling what another person feels, you are experiencing empathy. Thanks to your brain’s “mirror neurons,” a concept still under neural investigation, empathy may arise when you witness someone in pain. For example, if you saw someone in distress, you may feel awful. This has even been witnessed in infancy, such as babies and toddlers who may start crying if they see or hear another child in tears.
Several interesting developmental psychology studies in Finland and Denmark have shown that empathy can be taught from an early age, as an active skill and strategy, so ‘baby, you were born with it,’ is not necessarily the only scenario. Just think about the possibilities of teaching empathy as an active life strategy and the possibilities for what that would mean across the world.
For more info: Why We Should Teach Empathy

It can be tricky to differentiate sympathy and empathy. The main difference? When you are sympathetic, you are not experiencing another’s feeling. Instead, you are able to understand the content of what the person is feeling. For example, if someone’s loved one has passed away, you may not be able to feel that person’s experience. However, you can understand that your friend is sad. This includes societal norms of grief and loss.

Compassion kicks empathy and sympathy to the level of activity. When you are compassionate, you feel the pain of another (i.e., empathy) or you recognize that the person is in pain (i.e., sympathy), and then you do what you can to to alleviate the person’s suffering. It is the basis of volunteering, community service, mentoring, and helping others.
At its Latin roots, compassion means “to suffer with.” When you’re compassionate, you’re not running away from suffering, you’re not feeling overwhelmed by suffering, and you’re not pretending the suffering doesn’t exist. When you are practicing compassion, you can stay present with suffering, actively.

Dr. Thupten Jinpa, was the Dalai Lama’s principal English translator and author of the training known as Compassion Cultivation Training (CCT).  Jinpa posits that compassion, trained in neural science, is a four-step process:
-Awareness of suffering
-Sympathetic concern related to being emotionally moved by suffering
-Wishing to see the relief of that suffering
-Responsiveness or readiness to help relieve that suffering through behavioral activity and reaching out.
For more info: Compassion Institute

I posit one additional concept, that does not yet have sufficient Cognitive/Neural research data. I call it the mind meld, or empath. It’s being with someone in the mindful moment or experience, and has been anecdotally described in indigenous cultures and spiritual practice. Think of Diana, from Star Trek; or the conduit described by the Iroquois, and dogs who stare into your eyes, which they do not do with any other species, except their beloved humans.

Also read:
The Neuropsychology of Dog Love

When I began my neuroscience studies, the epitome of writing and research was represented by neurologist, Dr. Eric Kandel. Many chapters in his landmark textbook ended with: this is all we know, and how much we still need to learn about brain functioning. Still true.I enjoy your neuropsychology questions and comments. And I love that people are interested in the brain/mind connection. They are forever spouses.

More info:
Mental Health and Empathy
The Science of Compassion
The Neuropsychology of Self Compassion

ADHD and social injustice

A common theme these past few weeks with clients has been a tendency to hyperfocus on social media, especially Twitter. Therapeutically, cutting back on social media as a mental health goal is a good idea, and sometimes taking full breaks. Some of my clients feel guilty if they are not watching/scrolling, and I call this phenomenon bearing witness. Protecting your mental energy, gives you energy.

While individuals with attention and concentration vulnerabilities, including anxiety disorders, ADHD, and autism spectrum have been perceived as ‘tuning out,’ the opposite is actually true, based on the neuropsychology research. Instead, they tend to be overly sensitive to disturbing imagery and social injustice.

Please check out the article in ADDITUDE: Whay Am I So Sensitive? Why ADHD Brains Can’t Just Ignore Unfairness.
Also read: On Hyperfocus.

On anticipation as habit: dopamine and desire

Intermittent reinforcement is a schedule of rewards for certain behaviors or responses but without any predictable pattern. In other words, the reward comes periodically, not every time it’s performed.

It’s the slot machines, where you sometimes win but you keep pushing the levers because this might be the moment, it’s the social media where you keep checking to see if somebody liked your post, it’s scanning all day for text messages and notifications, it’s the relationships where sometimes somebody is nice to you, but not all the time, it is the shopping app that says you liked this, so maybe you would also like this; it is the personal visual stimuli recommendation that pops up on your screen because you previously watched something; it’s the unpredictability of a parent who at times showers you with attention and sometimes completely ignores you, it’s the hard to get reward.

Many people think that the neurotransmitter of pleasure is released when the brain receives the reward, but dopamine is actually released in anticipation of a reward. It is the excitement of craving and desire. A recent study found that people have higher dopamine levels when they shop online and they are waiting for their item to arrive, rather than buying it immediately in a mall.

Dr. Robert Sapolsky, a neuroscientist at Stanford, studied monkeys in conditions where they humanely received coveted food rewards by pressing a button. After 10 presses, the treat appeared. There was a surge of dopamine while pressing the magic button. It’s the dopamine that keeps the monkey pressing the bar until the treat arrives. Dopamine significantly diminished once the monkey participants realized that the 10 presses was all they consistently had to do. Immediate gratification is, well, immediate. And then over.

In a second experiment, the monkeys received the food treat only 50 percent of the time, randomly, after they pressed the bar. What happened to the dopamine in that situation? Twice as much dopamine was released when there was only a 50/50 chance of getting the food treat.

Our brains are wired for dopamine. It’s part of us. But the constant craving for dopamine can lead to repetitive behaviors and ultimately deplete the very receptors evolved to receive dopamine. Understanding our anticipatory nature and desire for pleasure is important to address behaviors that can become unhealthy or even addictive. The chase becomes the pull. There are strategies to reduce this cycle.

Check out Dr. Sapolsky’s book which is very interesting and highly readable, on our propensity for good and bad behaviors, which are not unrelated.

12 Facts About Depression and South Asian Mental Health

South Asia is a broad region that includes close to 2 billion people. Encompassing India, Pakistan, Bangladesh, Nepal, Afghanistan, Sri Lanka, Bhutan, and the Maldives, South Asia is huge.

South Asia is a suicide-dense area but with only a handful of peer-reviewed studies assessing the relationship between depression and suicidal behavior.

South Asia represents approximately one-quarter (over 23%) of the global population. Depression affects close to 90 million people in South Asia. The World Health Organization (WHO) estimates that almost one-third of people suffering from clinical depression worldwide live in South Asia, making the region home to a large majority of the world’s depressed.

Suicide is a global public health issue (World Health Organization, 2021). WHO estimated that suicide isthe fourth-leading cause of death worldwide among 15–30- year-olds. It is the result of a complex interaction between several risk factors which may include biological, personal, social, psychological, cultural, and environmental factors, but psychiatric disorders are one of the most crucial risk factors (WHO, 2014; Arafat and Kabir, 2017). Depression numbers are probably underreported in South Asian communities because of years of stigma about mental disorders.

About 90% of people who die by suicide experience some form of psychiatric illness. Among psychiatric disorders, clinical depression is the most common risk factor for suicides.

Mental illness is taboo in many South Asian communities. Discussing mental health in South Asia has yet to be socially normalized. South Asian religious and cultural influences often do not consider mental health a medical issue, referring to it as shameful and even a “superstitious belief.”

A 2010 study by the mental health campaign Time to Change (www. found that South Asians rarely discuss mental health because of the risk the subject poses to their reputation, family, and status.

South Asian languages do not have a word for depression. There is dukkha (universal suffering); pagal (derogatory word, crazy); and shikasta (broken). Many South Asians are unable to express the specific condition of depression in their language. As a result, they often downplay it as part of “life’s ups and downs.” This language limitation and difficulty describing symptoms also makes diagnoses and treatment difficult.

Depression is a major contributor to other global health problems. Medical experts have found a correlation between the symptoms of depression and the perpetuation of chronic illness, such as cardiovascular disease. Depression exacerbates other health conditions.

Postpartum depression in South Asian women is often undiagnosed and unrecognized. The gender of the baby, domestic violence, secrecy, and poverty are all factors that put new mothers at a higher risk for postpartum depression. The stigma surrounding mental health prevents new mothers from receiving mental health care or support during after pregnancy.

Bangladesh, Sri Lanka, and Indonesia are three countries who have recently emphasized mental health as a “top priority” in public health. In 2021, WHO lauded their work and the important step it takes towards normalizing and treating depression and mental illness, as illness.

Non-government organizations (NGOs) have had a positive impact on mental health care. In countries where the government is not willing or able to make mental health a priority, NGOs are providing crucial support to people suffering from mental health issues. NGOs in South Asia have expanded their community-based programs and are providing specialized mental health services. For example, in the Maldives, a number of NGOs are offering rehabilitation, life-skills training, educationsl information, and resilience-building to citizens. These efforts have begun to increase the access South Asians have to mental health care with decreased stigma.

Mental disorders are bad for work and family life. People with major depression struggle to take care of their family, complete self-care tasks, pay bills, and be productive in the work place. Although poverty rates in South Asia are declining, the region accounted for nearly half of the world’s “multidimensionally poor” in 2017. Providing mental health care to South Asians may be a major step in helping to eradicate poverty within the region.

According to the World Bank, strong mental health is a contributing factor to not only the wealth of nations but to increased quality of living and productivity for families and individuals.

Read more about this:  South Asian Mental Health

***Call 911 if you or someone you know is in immediate danger or go to the nearest emergency room.
988 Suicide & Crisis Lifeline
Call or text 988; Llame al 988 (para ayuda en español)
Use Lifeline Chat on the web.
The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Call or text 988 to connect with a trained crisis counselor.
New: If you are worried about a friend’s social media updates, you can contact safety teams at the social media company. They will reach out to connect the person with the help they need.

Dogs and Stress

We’ve known for a while that dogs can be trained to sniff out seizures, infections, diabetes, extremely elevated blood pressure, and sometimes even cancer. Therapy dogs and service dogs can be trained to help people with movement and balance problems, panic attacks, PTSD, cognitive fogginess, (including getting up and going in the morning), poor attention and concentration, and executive functioning and memory loss.

A series of recent studies indicated that dogs are also responsive to the release of cortisol and adrenaline in humans, using their exceptional sense of smell, the human stress hormones. If you have a dog that is very attentive, or at least stays near you when you are not feeling well or having a bad day, they are not only showing the affection and loyalty they have for you, they FEEL you.

One patient who has a rigorous job with deadlines throughout the week reported that she can be sitting tensely in her home office and will look up to see her dog staring at her. Instead of sleeping, he monitors her. When she’s not doing well, suddenly, her dog will start panting I have heard this phenomenon from dozens of patients.

Dogs can smell your stress. And they know something is wrong.
Also read: Mindfulness in Fur.

On Coupling

Below is a portion of a couples’ questionnaire that I send people who are coming in for relationship counseling. Sometimes it’s to address moving in together, getting engaged/married, becoming parents, or even breaking up in an honorable fashion: the next step questions.

I love working with couples. There is a magic that happens when individuals decide to share their lives. It’s also hard work.

Usually, when I start working with a couple, I ask questions that are streamlined for their specific situation. This questionnaire is extremely baseline; I work with couples who are in different combinations and permutations of relationship; there is no formula.

Here are some of my questionnaire items to possibly discuss with your partner.

Children related questions

  • At this point in the relationship, you may already know the overall “will we or won’t we” as regards to raising a family. But digging a bit deeper into the topic can be a beneficial exercise, since it can reveal areas you might want to work through.
  • How many children do we want to have, and what’s our ideal timeline? Will we adopt?
  • Do we want to hire a babysitter or nanny? Will our children go to day care? Or will one of us stay home?
  • If yes to a parent staying home, how long before we return to work?
  • Will our children attend public or private schools? How important is this to each of us, and why?
  • How do we hope to parent our children? What are the values that we find most important as parents in raising children?
  • What will we do if our parenting styles or values conflict?
  • What role will our extended family play in our parenting?
  • How will we speak to our family members who may favor a different parenting style from what we hope to implement?
  • What will we do if one of our children/child has special needs or is diagnosed with learning or behavioral concerns?

Religion and faith related questions

  • Whether you’re devout, undecided, or somewhere in-between, religion and spirituality are typically a tough topic for couples to discuss on their own. You may also have your own faith based counseling that you would like to engage.
  • Secular couples counseling provides the opportunity to voice your desires and concerns by asking questions like:
  • How important is religion / faith to each of us?
  • How much influence do we want religion to play in our lives and our children’s lives?
  • Which religion will be taught and celebrated in the home or could different religions be celebrated?
  • Will we celebrate religious holidays? If so, to what extent? What will those holidays look like?
  • What are our core spiritual values as individuals and as a couple, and how do we see ourselves upholding them?
  • How can we handle any conflicts between our individual values?
  • What happens with our extended family situations if our religious values are not commensurate with theirs?

Money related questions

  • For many, living together/marriage marks the point at which income and finances may become a shared responsibility.  But it’s not always as easy as opening a joint bank account and calling it a day; you may also need to discuss the nitty gritties of the “f” word… finances:
  • How much do each of us expect to contribute to the household?
  • How much of our income will we spend on our own personal hobbies or interests?
  • How much of how income do each of us envision saving
  • Should we have a monthly budget? How will we set it and stick to it?
  • Do we want to combine our finances completely or keep some accounts separate?
  • How much debt do we have, and how much money do we have saved?
  • What will we do if we have an emergency expense or an unexpected loss of income?
  • How much do we plan to spend on shared interests, like vacations? If we plan to spend some of our money on a vacation, what type of vacation do each of us enjoy?
  • What is the importance of earning money to each of us?
  • How much is expected from each of us in terms of earning money for the family?
  • What happens when we have significant discrepancies in income?
  • What are the emotional reactions we have around money, earning, spending, saving?

Work and career questions

  • One person’s long hours is another person’s normal. Make sure you and your partner are on the same page about career expectations.
  • How much will each of us work?
  • Do we expect or want to make any significant career changes in the future?
  • How will we balance careers and childcare if we have children?
  • How can we support each other in our career goals?
  • How much sacrifice is each of us willing to endure for the other person’s career goals and the pursuit of success? What if one of us becomes unemployed or under employed?
  • What happens if one of us wants to pursue future goals that require time and any commitments such as advanced degrees?
  • How many hours per week does each person expect the other will be away from home (or working at home) in order to pursue career goals?
  • How will we negotiate future ambitions and endeavors, such as one of us wanting to start a business or go into self-employment
  • Questions related to where you want to settle, in the short and long-term. Whether you both want to move, or put down roots where you are, it’s great to touch base now.
  • Where do we want to settle down? Will we want to live in the city or in the suburbs?
  • What is our shared vision of the future? Are there any significant differences?

Sex related questions

  • It’s a tricky topic, but crucial to be honest about. After all, who better to discuss sex with than your partner? NOT talking about sex can become a habit that makes it harder to communicate in the bedroom.
  • How important is sex to each of us?
  • How much sex do each of us envision having every week?
  • How will we handle any problems in the bedroom down the line?
  • How is our current sex life going? Do either of us have any unmet sexual desires?
  • Are we monogamous in the longterm? What will we do if either of us is interested in changing our relationship model in the future?
  • What other forms of intimacy and romance are important to us?
  • Do we make time to be together as a couple or do our other responsibilities take over?
  • Are we able to talk about sex, from preferences to complaints?

Social lives questions

  • Every relationship needs a healthy balance between friends, family, career, self-time, and each other – what does yours look like?
  • How much socializing is important to each of us? How much time do we want to spend with each of our friends and family?
  • How important is maintaining friendships outside the marriage to each of us and to what extent should our attention and shared resources be devoted to these (e.g. weekend bachelor and bachelorette parties, girls’ night out, weddings, showers, visiting out of town friends, etc.)?
  • How close are each of us to our immediate and extended family members? How much time do each of us expect to spend with our families (alone and with one another)?
  • How comfortable do you feel about your partner having friends of the opposite gender?
  • What are the rules around social media and having online friendships with opposite gender connections?
  • How do we feel about time spent away from family that is spent with friends, individually and as a couple?
  • Do we have friends that we share, individual friends, or both? What happens if we don’t like our partners’ friends?

Vacations and holiday related questions

  • How do each of us envision spending our weekends? Where do we want to spend them?
  • How will time off, and holidays, be spent?
  • How much of our vacation time will be devoted to visiting family versus traveling together as a couple or family?
  • Do we have a bucket list of places that we both want to explore?
  • How much time and expenditure do we want to spend on holidays?

Conflict resolution and decision making questions

  • How do we resolve conflicts?
  • What communication style works well for us, and where do we struggle?
  • How can we effectively express difficult emotions like anger and sadness?
  • How will we make major life decisions together?
  • Where can we turn for support if we disagree about a big decision in the future?

Household responsibility questions

  • How do we divide up household duties?
  • Do we have any particular challenges around sharing a household?
  • Which tasks will (or does) each partner handle?

Personal history questions

  • What are our plans for combining our different backgrounds, whether racial, ethnic, cultural, socio-economic, or otherwise?
  • Do we expect any conflicts related to our different backgrounds?
  • How might we plan to resolve those potential conflicts?
  • How do we handle medical and mental health issues?
  • How do we feel about the health of each other and how to best be supportive If your partner is under the weather?
  • What happens if one or the other becomes physically or mentally disabled?

Also read Healing in Relationships: Imago Therapy for Communication.


Happy Doctors Day to all my friends, family, and colleagues. I’m so proud of all the work that you do and how difficult it is.

We are having a huge doctor shortage in this country which is getting worse, day by day. It takes me weeks and endless phone calls to find a primary care referral for my neuropsychology patients. All my experienced physicians are completely full and they work a lot. Doctors are not there ‘for the money.’ The amount of education, work, stress, hours, and student loans is immense.

I want to mention three superhero doctors in my life who influenced me as a child and young adult:

My uncle, Dr. Paul Fischer, is based in Augusta, GA, and has practiced family medicine for over 35 years. His first practice was a solo rural one in Weeping Water, Nebraska, where he worked with many indigenous American patients, with deep compassion and gentleness. He moved from there to the Medical College of Georgia where he was a professor of Family Medicine, considered to be the less glamorous sibling of the medical practices. While there, he published a controversial article in JAMA showing that children as young as 4 years old, routinely recognize “Old Joe” the Camel cigarette cartoon character. Smoking was commonplace in preteens and teens and highly addictive. His research led to a long legal battle with the tobacco industry. Let’s just say that they don’t play nice. Thanks to him, cartoon characters and cigarettes are no longer friends.

My uncle Dr. Teepu Siddique is the foremost scientist and neurologist in the world helping ALS patients. His team at Duke Medical Center was nominated for the Nobel prize in medicine, giving some hope to families affected by this terrible disease. I have to add that he gave me my first medical research job, and I can still run DNA in a centrifuge in my sleep.

He and his collaborators, including my friend, Dr. Alan Roses (RIP) kind of adopted me. We went out to many lunches at red lobster and talked about neurogenetics (I wasn’t joking when I said I’m a science geek). His team discovered the first known cause of ALS, linking mutations in the SOD1 gene to the disease, and developed the first models for ALS and ALS/dementia, now used by investigators all over the world. Over the years, Dr. Siddique’s research has pioneered additional causes and signatures for both familial and sporadic forms of the disease and paved the way for targeted treatments.

I saw my friend’s father pass away from ALS, and I am so grateful for advances in this area. Dr. Siddique is a professor in Feinberg’s Ken & Ruth Davee Department of Neurology, as well as the Departments of Cell and Developmental Biology and Pathology, Northwestern U.

My paternal aunt, Dr. Asma Qureshi Fischer, perfected pediatric ultrasound, a noninvasive neural-imaging procedure to detect severe neurological disorders in infants. She patiently allowed me to work in her office and participate in hospital rounds over several summers. If you are ever planning on having children, I would not recommend hanging out in obstetrics wards.

Most certainly, my family and many mentors and friends helped me fall in love with science and neuropsychology. We are complete nerds combined with an aching desire to heal.

Thank you to all the doctors out there.
We need you.

Ireland and India: on connection

In the center of the Irish county seat, Sligo, sits a statue of Rabindranath Tagore, gifted in 2015, commemorating the Nobel prize winning National Poet of India. In a country with only 50,000 citizens of South Asian descent, Tagore shared a connection with William Butler Yeats, the poetic voice of Ireland. Both poets were interested in the relationship of poetry, music, spirituality, the struggles of everyday life, connection, and anti-imperialism. They followed each other’s work, and finally met in London.

Across continents, their works served as moments of identity shared between the Colonized. I call it ‘Partition poetry.’ Notably, both poets won the Nobel prize, 10 years apart, Tagore in 1913 and Yeats a decade later, in 1923. Although far from ideal, as by default Ireland was both a colonizer and the colonized, their fascination with the work of the other is striking. And inspiring.

I ranted to the knave and fool,
But outgrew that school,
Fit audience found, but cannot rule my fanatic heart.
-Remorse for Intemperate Speech
(William Butler Yeats, 1931)

Freedom from fear is the freedom.
I claim for you!
Freedom from the insult of dwelling in a puppets’ world,
Where movements are started through brainless thoughts repeated through mindless habits.
(Rabindranath Tagore, 1913)

Beannachtai na Feile Padraig.

On Hyperfocus

People with ADHD have difficulty focusing. But many can also hyperfocus on things they’re very interested in. Parents come to me and say my kid can play Fortnite for eight hours, why can’t they focus on the three regular chores they have to do in a week?

The idea of hyperfocus can be confusing. How can a person who has trouble focusing on most things lose themselves in a video game, movie, series, sport, or craft project for hours? It might look like that person doesn’t really struggle with attention.

Hyperfocus is a common but sometimes confusing symptom of ADHD, is the ability to zero in intensely on an interesting project or activity for hours at a time. It is the opposite of distractibility, and it is common among both children and adults with attention deficit hyperactivity disorder.

But actually having good focus requires two opposing elements. People need to be able to pay attention even if something isn’t that interesting. Many things are not interesting. And that is reality. Why do I have to sit through this meeting, take this class, work with this team, read this book, do such and such? Why the heck am I taking algebra or physics?

Secondly, they need to be able to not pay attention to something interesting, or something that’s bothering them (the biggest distractions are anxiety or sadness), when they need to focus on doing what they’re doing because it’s more interesting than what they’re being asked to do. Un-focusing and focusing. One of my clients reported that it’s like being in a tunnel, you only see one thing. Both good and bad.

The neuropsychology of hyperfocus.

Like distractibility, hyperfocus results from abnormally low levels of dopamine, a neurotransmitter that is particularly active in the brain’s frontal lobes. This dopamine deficiency makes it hard to to take up boring tasks. Many of our life tasks can be mundane, repetitive, and frustrating.

So, what can we do? How can we harness the power of hyperfocus?

Mindfulness matters.
Focus can be combined with a mental health exercise: when you take out the trash, you can visualize an exorcism of anything nasty that happened over the week. I teach imagery, this is your chance to take out your accumulated trash.

Purpose matters. And Distraction helps.
I have a client who stands in a queue to pick up her kids after school for almost an hour. She loves them with heart and soul and wants them to be safe. In the meantime, I gave her a podcast that has appeal. Zoning out in the parking lot scrolling through social media was not making her very happy. Now she is stimulating her brain with a great podcast she rarely gets to fit into her busy life.

Practice matters.
Some of my teenagers have trouble with mindfulness and attention. Simple exercises can include, coming into a room, such as the kitchen. What do you see, what do you smell, what is the lighting? What do you hear. It pulls your attention back. And requires practice.

Timing and dosage.
Give yourself time you can play the heck out of the game that you love, watch the series that you are fascinated with, immerse yourself in the best book. Plan your binges. They don’t have to control you.
Also see, “On News Anxiety.”

Set external cues and reminders.
If you know you’re going to be lost in cyberspace, create multiple reminders. Set multiple alarms. Remember that we need to get up and move our bodies every 25 to 30 minutes.

Work with your own circadian rhythms.
If you work best in the morning with heightened alertness, do your toughest work then. If you’re tired in the afternoon, save that time for more rote tasks.

Engage with an accountability buddy.
This can be as simple as having a reminder that you need to get your stuff done, and then you can relax. Your buddy might say, we’re going to watch a great show tonight. Let’s get our work done.

Don’t set impossible standards.
Most people, optimally, cannot focus after 30 to 40 minutes, especially on complex tasks. Take a break. Regularly.

If there’s something that you really dislike doing, see if you can trade it off. We put off tasks that are aversive. I have a client who has sensitivity to washing dishes, it truly grosses her out, but she can do laundry and fold clothing like a luxury retail store. Ask your partner, child, roommate, colleague, to do things that you don’t love and vice versa.

Embolden Psychology

Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

Thank you for contacting us.