Interview: Why you shouldn't trust boredom | Kevin H. Gary (re-release)

0:05This is Ted Health and I'm your host Dr. Shoshana Ungerleider. Imagine this. You've been channel surfing on the couch for a while. And you're getting really bored. But finally, you land on a wildlife documentary. Not your usual cup of tea, but you give it a shot. Fast forward 20 minutes, and you're on the edge of your seat, marveling at the intricate dance of nature. This shift from mundane to mesmerizing is the heart of Kevin Gary's thought-provoking 2023 talk at TEDx Valparaiso University. Gary, a seasoned educator, invites us on a journey through the often-ignored corridors of our mind, exploring a topic that we all encounter, yet rarely ponder.

0:57Boredom. In his talk, Gary explains how this seemingly dull subject can actually reveal layers of our everyday experiences and decisions. Our boredom and how we snap out of it can tell us a lot about ourselves. So if you've ever found yourself mindlessly scrolling through your phone or doodling during a meeting, tune in. And stick around after the talk for my conversation with Dr. Elizabeth Harstad. Dr. Harstad is developmental behavioral pediatrician and researcher at Boston Children's Hospital, specializing in developmental and behavioral conditions, including attention deficit hyperactivity disorder, or ADHD, and autism spectrum disorders.

1:49I will always remember my son's first day of school. Lucas was five years old, and he was going to kindergarten. And he was so excited. He was going to take the bus, and we were excited for him. And I'll never forget that day when I came home, I was eager to check in with him to hear, how did it go? And Lucas's response was, Dad, I'm tired of hearing about hallway procedures. I found his response both amusing and sad. Amusing because I thought, oh my gosh, you have a lifetime of hallway procedures that you're going to have to work through. And also amusing because it captured so well how schools and institutions can just grind us down with their bureaucratic rules and monotonous procedures.

2:33But I found it sad because this was his first day of school. And his takeaway on that very first day was that school's boring. This is a boring place. However, he's going to have to learn to deal with boredom. It's something we all learn to deal with. Boredom is a common and familiar problem. And I think at first it can seem like a trivial problem. If your board just finds something interesting, move on to the next thing. But actually, I'm going to argue that it's far more complex and that it needs our attention. And I'm going to offer three takeaways for how to contend with boredom well. In schools, boredom is a big problem.

3:12An overwhelming majority of high school students report being bored in school. And this is a problem because when students are bored in school, they begin to lose interest. They can't focus. And when students are bored in school, they start to misbehave. I was a high school teacher, and if my students were bored, I was petrified because I was going to have problems. This was going to be a disaster. And if students are chronically bored year after year, eventually they just drop out and peel away from school altogether. But boredom is not just a problem in schools. It's a problem that tracks us beyond schools.

3:44There are several troubling addictions that are linked to boredom. When we're bored, we drink too much, we eat too much, we spend too much money, we buy things we don't need. There are entire industries that are designed around making us bored. And so boredom has some really problematic behaviors linked to it, but even more than these troubling addictions, there are also these smaller things. The half-listening to friends and acquaintances when we're bored. Or just the way we idle our time when we're bored. I'm dating myself, but if I could take back the 10 ,000 hours I put into Tetris and put that into actually playing guitar, I'd be a professional musician right now.

4:21That was kind of a joke. Anyway. So, boredom is something we need to look at. And when we look at boredom, we tend to think about it objectively. I'm bored by this teacher, or I'm bored by this book I'm reading, or this person I'm talking to. And boredom tends to objectify things and actually be quite judgmental and arrogant. That's a boring person. That's a boring book. But in truth, boredom is both objective and subjective. We're actually making a judgment call, deciding whether something is boring or not. And we know that what bores one person could actually be very interesting to another. So in this respect, boredom is kind of a curious and perplexing mood state.

5:00What do we make of it? It's kind of like a dashboard light when you're in your car and a light goes on and it gives you very clear directives. You need to get gas. You need to get oil. You need to put air in the tires. the problem with the boredom light is it goes on and there's no clear direction. We're not sure what to do with it. And most of the time, we don't even notice the boredom dashboard light because it's going on all the time. It's kind of blinking and it just becomes white noise and we're dealing with it. We're dealing with it without even realizing it. Day in and day out, we're constantly navigating away from boring spaces into interesting spaces.

5:33And how do we do this? There are two dominant ways that we've evolved to contend with this troubling mood state. On the one hand, you've got avoidance. So if I'm in a boring situation, the first move we make is how do I get out of this? I can physically get out of this. Or what do I do? I daydream? Or the most obvious thing we do is we check our phones. Our phones are these sophisticated boredom avoidance devices. And we avoid boredom because it's actually painful. I don't know if you've ever felt the pain of boredom. The pain of boredom was illustrated in a recent study at the University of Virginia.

6:06They asked subjects to come into a room and just sit with their thoughts for 15 minutes. And they could do that or they could put their finger in a machine and receive a painful shock. The results of the study were, pun intended, shocking. 30 % of the women and 60 % of the men chose to shock themselves rather than sit with their thoughts for 15 minutes. All of this is to say that we would rather have physical pain, many of us, than the pain of boredom. So avoidance is the common go-to way that we contend with it without even thinking about it. It's automatic. The other strategy that we employ is resignation.

6:46You've perhaps heard grown-ups say to children when they complain of boredom, that's life. Get used to it. And so the idea is that you just have to endure it. You just have to push through it. I'm a teacher of teachers, and a privilege I get is I get to see teachers across all grade levels, and I've seen some incredible spaces where the teaching is dynamic, engaging, it's meaningful. If there is boredom, it passes. The students know how to deal with it in a good way. But sometimes I go to classes and it's boring. And usually in those classes, the students are misbehaving. And that's completely understandable.

7:19And I would say even appropriate sometimes to let the teacher know that they need to change it up here. But sometimes I go into a boring classroom and the students are not misbehaving. I was in a classroom a few years ago, a seventh grade classroom, and the students were tasked with copying a PowerPoint word for word for 45 minutes. I was bored out of my mind. And I turned to the student next to me and I said, is this kind of what you do? And he said, we do this every day. And what amazed me was the students were docile. They were compliant. I expected, I actually hoped there would be a protest or a revolution.

7:51I thought this teacher should be punished for having such a boring class. But instead, the students just were passive. They were just resigned. My kids were younger. They would complain to me, Dad, I'm so bored. There's nothing to do. And there are two things going on there in that comment. The first is a lack of imagination. I'm so bored. I can't see anything worthwhile to do. That's resignation. And then there's also a loss of agency. I'm so bored. There's nothing I can do to get out of this. So we have resignation on the one hand, and we have avoidance. These are the two common strategies that we employ without even recognizing it.

8:29I'm interested in what is a practically wise way, a middle way, between avoidance on the one hand and resignation on the other. And I think about this in light of two stories from my own life. After college, I lived in a house in Chicago with three teachers. And one of my roommates, Mark, I met him the first day and after, probably within the first day, I decided he was just kind of dull. He kind of took his time to make his points. And I decided that I was going to limit the amount of time I spent with Mark. I was going to avoid him. We were roommates, though. I would see Mark every day. He used the same bathroom.

9:05Every day after school, we would talk about teaching. And I discovered that Mark actually was a really thoughtful teacher. He was a creative teacher. He was an innovative teacher. And he wasn't just trying to improve his teaching. He was also trying to improve himself. And he was always thinking about work and life and figuring out the right balance. And over time, I realized Mark is not boring. He's actually a very, actually he's wise and he's a dear friend to this day. But my initial assessment of Mark as a boring person was just completely wrong. The mood state was giving me information that I was not reading correctly.

9:37The second story is from my first year of high school teaching, which the first year is demanding work and you're kind of looking for shelter and comfort. And I found a group of teachers to have lunch with and would go there to eat lunch. But eventually the conversations were just complaint sessions, day in and day out. And we usually complained about administrators. That was our number one target, especially administrators who hadn't taught. Our second complaint was maybe a difficult student or parent, but day in and day out, it was this negative loop. It's like being stuck in the first part of the movie Groundhog Day.

10:09And it was just unending. And eventually, I just got bored with this conversation. And I pulled away. I began to eat lunch in my classroom by myself. But eventually, I found other teachers who were also vigilant about steering away from complaint culture, which is addictive. It seems interesting, but eventually, it gets very, very boring, complaint culture. And instead of complaining, they would talk about books they were enjoying or hobbies that they loved or what went well in their teaching. And these were conversations that I found very interesting. And also they were restorative. They lifted my spirits to go in and teach my classes.

10:47I share these two stories because in both instances, I was experiencing boredom. But what to make of it was not clear. And so I want to offer three takeaways. And I'm thinking of young people as they figure out strategies for contending with this troubling mood state. The first takeaway is that boredom should not be trusted. it. We tend to trust boredom. We make an implicit judgment about something or someone and decide it's boring. And it's arrogant. It's judgmental. And it often is wrong. We need to take a careful look and make sure that there might be something here worthwhile, worth attending to.

11:25So don't trust boredom is takeaway one. The second takeaway is we need to protect our attention. A bored mind is primed to get distracted from distraction by distraction. It is looking to be distracted. And when we think about the things we care about, our friends or something we're trying to get good at, or a hobby that we love, each of these things will be afflicted by boredom. It will come. And if we are in an environment where we're easily distracted, boredom will get the better of us. Don't trust boredom. Protect our attention. And then finally, we need to talk about boredom. We all have strategies that we employ.

12:05We need to name those strategies. There was a great writer in the 80s who described our modern life as a sophisticated boredom avoidance scheme. Walker Percy said that. The scheme is far more sophisticated today. We know that. But to the extent that we're not reflecting on it and thinking about it, boredom plays us and gets the better of us. But the extent that we're reflecting on it and thinking about it, we can put boredom in its place and give our attention and protect our attention to those things we love and the people we care about. Thank you very much.

12:41Welcome back, TED listeners. It's Dr. Shoshana again. I love the idea of guiding your boredom to protect your attention. It's a good tactic to keep your brain active and not falling into distraction traps. Kevin Gary's talk also reminded me of my husband's stories of being bored out of his mind at school, which is hard for me to imagine since I loved school. But the more I learned about his childhood, it got me thinking, could he have ADHD? And it turns out he does, but he was diagnosed as an adult. I invited Dr. Elizabeth Harstad, a developmental behavioral pediatrician and researcher at Boston Children's Hospital, to share how people of all ages with ADHD can guide their attention.

13:31Dr. Harstad specializes in developmental and behavioral conditions, including ADHD and autism spectrum disorders. After completing her medical education and fellowship at Loyola University and Boston Children's Hospital, respectively, she also earned a Master of Public Health from Harvard, focusing on clinical effectiveness. She's published numerous academic articles on ADHD. Welcome to TED Health. Thank you for joining us today. Thanks so much for having me. I appreciate the opportunity. My first question for you is, why do doctors often consider boredom as a sign of ADHD in children? And how can you tell the difference between normal boredom in kids and the kind of boredom that might be a sign of ADHD?

14:21That's a great question. So to start, I think I'll just first explain a little bit about ADHD itself. So ADHD is attention deficit hyperactivity disorder. And there's actually three different subtypes of ADHD. So some children have inattention subtype where their primary symptoms are inattention alone. Some children have ADHD hyperactive impulsive subtype where their main symptoms are hyperactivity and impulsivity. And some children have both. So combined subtype where they have both inattention and hyperactivity impulsivity. And I think the tricky thing about boredom is all children and all people can experience boredom.

15:00But children with ADHD, often with the inattention symptoms, may have a hard time sticking with one activity for a while or finding activities or things to entertain themselves. And so they also may like a fast pace and constantly to be busy. And so they may express boredom more often or in more situations than children without ADHD. So while boredom isn't a core symptom of ADHD, we often see that for children with ADHD, they may report being bored fairly often. And in your experience, how often is boredom in kids misinterpreted or even maybe misdiagnosed as ADHD? Does that happen? Well, I think what we do worry about is that a child may manifest some symptoms of ADHD, but they're not across all settings or they're not causing significant difficulty.

15:54And sometimes in those situations, a child could be misdiagnosed with ADHD. So we always want to make sure if a family is seeking an evaluation for their child, that the evaluator collects information about the symptoms occurring in multiple settings. So are the symptoms occurring at home and at school or in just one setting? And also, are those symptoms really causing an impact? If a child is having a hard time paying attention, yet there's no difficulty with following the directions at school, with doing academic work, with following the routine, that may not be at the level of actually an ADHD disorder because there's no functional impact.

16:32Okay. So I want to go a little bit deeper into attention. And so in thinking about children who have ADHD and those who don't, how do the typical strategies for managing attention differ between those kids? Well, I think it can be helpful to use strategies for all children. And so I think the strategies that we often talk about for children with ADHD may be even more helpful or even more needed. But I don't necessarily think about differentiating what strategies we use, maybe just the importance of making sure that we're using strategies. A child with ADHD may not be able to fulfill their full developmental potential if they're not given the strategies and supports to help them be successful, whereas a child without ADHD may be able to overcome their difficulties just by kind of trying a little bit harder.

17:26Okay, we're going to dig into some of those strategies in a little bit. How does the digital age sort of with constant stimuli affect kids with ADHD in terms of their attention? Yeah, that's a wonderful question. And I think that that actually impacts all children. There is a lot of emerging research on whether that is preferentially impacting children with ADHD. And some studies suggest yes, and other studies suggest it's an impact just for all children. The American Academy of Pediatrics actually has a clinical guidance report on social or on just media use in general for children. And it really emphasizes having families think about the ways in which children are using media.

18:09So for example, if a child's watching short clips that just move quickly from one thing to another without a common theme, that may not be helping a child to work on sustaining attention and focus. And that's often done in isolation. In comparison, if a child sits with family and watches even a TV show or a movie, and there is a beginning, a middle, and an end, and there is sequencing, and there is comprehension about what is happening. And ideally, if they're with other people, they can talk about the meaning of what they're watching. That is obviously a different kind of digital interaction than those short clips.

18:45So we have to think about how media and the digital media is being used. And are there specific activities or therapies even that you recommend to improve attention span in kids with ADHD? So I think about the kind of treatment approach for ADHD based on the child's age kind of broadly. So for younger children, which is children less than six, we really think about the emphasis or focus on behavioral accommodations and supports. That may look like a family working with a therapist or psychologist to work on ensuring consistency at home, scaffolding the home for the child to be successful, ideally accommodations and supports in the school setting.

19:27And then for a child who's six and older, the American Academy of Pediatrics recommends that clinicians also talk with families about consideration of a medication, which if it is used appropriately prescribed and monitored closely, may actually improve attention and reduce the core symptoms of ADHD. And can you tell us what scaffolding is? Because I'm not familiar with that term. Sure. I mean, it can look different depending on the child's age, but it's more about ensuring that the child understands expectations, has follow through when those expectations are supposed to be met. So an example of that may be, does the child have a routine for when they come home at the end of the day after school or after wherever they are after school?

20:11Do they come home and put their backpack in the same place, their coat in the same place? Do they take out what's in their backpack? A lot of those kind of internal supports that we often create in the family setting, but making sure the child starts to develop a routine that's helpful for them. So how can parents and teachers work together to really create environments that manage and maintain attention, help kids with ADHD really thrive? Yeah, that's a really important question because I think it's crucial for families and school staff to work together. One recommended strategy is the use of what's called a daily report card, where the school staff can keep track each day of how the child's doing.

20:57There may be set items, depending on how a child's paying attention or staying on task or following expectations. And then a sheet goes home to the parents so they understand how a child did that day. And then there can be positive reinforcement at home. If the child has been successful, that can be praised and reinforced at home. And also parents can start to notice if there's a pattern of challenging behaviors, then the parents are aware of that as well. So now transitioning to adults, how do the challenges of attention management evolve from childhood into adulthood for people with ADHD? Well, for many people who have a diagnosis of ADHD in childhood, their symptoms may continue to persist throughout adolescence and into adulthood.

21:42That's not the case for everyone, but I think that families can be supported by thinking that that is a possibility for their children and therefore starting to plan early about transition. And by early, I mean in a clinical setting and through the schools, we want to think about transition starting around age 14, thinking about what is the expectation for the child after high school. And depending on what that expectation is, how can we build the right skills and support the child so that he or she can go on to achieve the success that they want after high school? An example for a child who is planning to move away to a four-year college after high school.

22:22In the high school years, we talk in the clinic about what is the child doing independently versus having their family do for them? Are they able to, you know, starting with get themselves a snack, make themselves a meal? Are they able to navigate finances? Are they able to do their own laundry? When we think about the interventions or supports for ADHD, I talk with teenagers about knowing themselves what supports are beneficial for them so that as they move outside of the home setting or into a secondary educational setting, they can advocate for the right supports. And obviously, that could continue into a workplace.

22:58And for those that are benefiting from medication prescribed by a doctor talking about who's remembering that they take the medicine each morning, if that is not happening naturally in the teenage years, I often recommend that families use a pillbox so that there can be oversight by the parents to make sure children are taking the medicine to limit the discussion in the mornings, but make sure that adolescents can gain the independence to ensure that they're taking the medication safely and only as prescribed. So you've talked about a few of them, but what are some other daily challenges that teenagers and maybe young adults with ADHD face due to difficulties managing their attention?

23:39Well, one challenge and concern that we always want to think of for adolescents with ADHD is the potential for risk-taking behaviors. And this can go along with managing attention because if we are constantly seeking out new high reward activities, we may be at higher likelihood of wanting to engage in risky behaviors, whether that is considering the use of substances, whether it relates to making safe choices with driving, in social interactions, making sure that there are safe choices. So in the adolescent years, while we are concerned about risk-taking behaviors for all adolescents, I think it's even more of a concern for an adolescent with ADHD, and therefore something that we want to make sure that they are getting counseling and support on so that they can be successful.

24:25I want to be clear as I'm talking about all the challenges today that we also need to recognize that many people with ADHD are extremely successful, and the research findings that we have are more on a group level, not an individual level. Our goal of recognizing potential problems is so that we can help support individuals with ADHD so that hopefully they will not have those challenges and they will be successful across all areas of their life, including with relationships. Absolutely. Okay, last question. Can you share any recent research insights or even success stories about managing ADHD in kids or adults or where you see the future of this space headed?

25:08Sure. In the past decade, there has been a lot of research that really emphasizes the potentially concerning impact ADHD can have on adolescents and adults. Now we are in an era where there is ongoing research to try to lessen that impact. And people are working on research to try to reduce the likelihood of adolescents developing substance use disorder if they have ADHD. And there's a lot of accumulated research about the driving risks for ADHD, including important research showing that if someone's benefiting from stimulant medication, they are a safer driver when they take it. And so in our clinical practice, we can counsel about that and ensure that people are taking all opportunities to be as safe as possible when they're driving.

25:59So I feel optimistic for those with ADHD that now that we have really recognized the potential impacts, we are now at a time where researchers are able to develop wide strategies to help them be more successful. Thank you so much for joining me today, Dr. Harstad. This was such an interesting conversation. Sure. Thanks for having me.

26:25That's it for today's episode. Thanks so much for listening. If you have feedback on the episode, I'd love to hear from you. You can find me on Instagram at ShoshanaMD. TED Health is part of the TED Audio Collective. This episode was produced by me, Shoshana Ungerleiter, and by Costanza Gallardo, edited by Alejandra Salazar, and fact-checked by Vanessa Garcia Woodworth. Special thanks to Maria Lages, Farrah Degrunge, David Biello, Daniela Balareso, and Michelle Quint. I'm Dr. Shoshana Ungerleiter, and I'll talk to you again next week.