Transcript of Dr. David Price video, “Empowering and protecting your family during the Covid-19 pandemic”

I’ll be publishing a number of articles on Covid-19 over the next few weeks, but today I wanted to put up my edited transcript of a video that has gone viral over the last few days. It’s a video call with  Dr. David Price of the Weill Cornell Medical Center in New York City. Dr. Price is a Fellow in Pulmonary Medicine and Critical Care, who works primarily with Covid-19 patients, so has had a good deal of experience treating this new illness.

The opinions expressed are his opinions, and some medical professionals disagree with some of his points particularly about the potential for transmission from speaking. In general, though, I found this interesting and useful. The complete transcript of his entire 57 minute talk is at this link:  Edited Transcript of Dr. David Price video, “Empowering and protecting your family during the Covid-19 pandemic”

Here’s the link to the original talk: https://vimeo.com/399733860 

Title: Empowering and protecting your family during the Covid-19 pandemic

Edited transcript. (Edited for clarity, headings, underlines and boldface are mine.)

surgical mask

I’m going to post a few excerpts from his talk here, and you can find the entire transcript here: Edited Transcript of Dr. David Price video, “Empowering and protecting your family during the Covid-19 pandemic”

My job is to decide which patients need ventilators and once patients are put on ventilators how long they have to stay on them. The treatment of these patients and so my whole long-winded point is that I’m kind of in a unique position to comment on what’s going on.

And what I mean by empowering is to learn about this disease. I know you guys have a lot of questions. We will get to as many of these questions as we can. But the main reason I want to have this call is that I don’t want you guys to be scared. We’re three months into this in the medical world and we understand this disease. So I’m going to go through ways to protect your family and then what to do if and when someone gets Covid-19 and how we can protect our circle.

What is Covid-19?

And so when the common questions I get is what is this disease look like? Commonly people have fever and cough and they have a sore throat. And then the virus goes to their entire body and what we have found is that the most likely place that this will affect is your lungs.

And so people will commonly have a cough but for about 80% of people, you just don’t feel good. You have a mild cough maybe have a little headache. The disease lasts from what we’re seeing between five to seven to fourteen days. Some people who have a mild disease by about day five are starting to feel better. People who aren’t feeling better usually start to get short of breath around day three to five and then start to feel better around that seven-day mark.

The first kind of big topic we’re gonna talk about and I think the reason I wanted to have this call is how to protect your family.  I think we’ve learned a lot and I want to kind of share all the stuff that I’ve learned so far with you guys. So I think the first thing is how do you get Covid-19. I  think that this is really important and we really learned a lot over the last couple weeks to months about how you get this disease.

The overarching theme is sustained contact with someone who has this disease, of which the vast majority is people with fever and aches. Or with someone who is about to get the disease. So someone in the next two days who’s going to develop symptoms of this disease. The way that you get this is the transmission of the virus almost exclusively from your hands to your face. From your hands to your face and into your eyes, into your nose or into your mouth.

How to Stay Safe by Keeping Your Hands Clean and Germ-Free

So the first step which I think is incredibly clear is to become a hand cleaning fanatic. Know where your hands are and know that they’re clean and sterile at all times.

So very simply for what this means for me in the city is that I walk around with hand sanitizer like Purell. So I walk around with Purell and so every when I leave my apartment everything that I see that I’m going to touch I make sure that I Purell first.

So when I leave my apartment door and I go to the elevator, it’s okay that I touch it with my hand, but then I Purell. When I go downstairs and I open the door it’s okay to touch the door. You can open it with your elbow, but if you touch the door then I make sure to Purell.

The second thing is you have to start psychologically working on the connection between your hands and your face.

You don’t realize that you move your hand, you know, you scratch your nose and so the virus has taken advantage of this and the reason why people get this disease is that you have sustained contact with someone. So someone at a party has this and you shake their hand.

And then you touch your face. It’s that simple. That is how you get this disease. So what does that mean? I think there are two practical things that you can do. One is just to start to be aware of when you touch your face. Atul Gawande is a Harvard trained surgeon who is very famous, has a recommendation for people to just start wearing masks. The idea here is not that the mask is going to prevent you from getting Covid because as I said, it’s not a disease that you are getting from the air. The reason to put on a mask is that you just stop touching your face.

And so what I would recommend is now when you’re leaving your house is to wear a mask. And I think those two things combined are incredibly powerful and will prevent the transmission of the disease in your family in ninety-nine percent of cases. Know that your hands are clean and sterile, and don’t touch your face.

Four important points (the Rules):

  1. Always know where your hands are and have hand sanitizer. When you touch stuff that’s outside your home, just make sure that you’re washing your hands.
  2. Start to learn how to not touch your face. A really good way to do that is to start wearing a mask when you’re out and if you want to practice,  wear a mask in your home.
  3.  You don’t need an N95 mask or a medical mask. Any mask will do because this is not preventing the disease. This is training you not to touch your face.
  4. And the fourth thing is just to stay away from people. Stay 6 feet away from people.

So I think this when you understand those four rules the next thing I think is so important becomes true.

You don’t have to be scared of the outside world. No, you don’t have to be scared of your neighbor.

So what do you do if you get sick? Quarantining Tips

If you develop a fever and you are otherwise fine, then isolate yourself from your family. So what does that mean? it’s just simply about the same rules about hands and touching your faces, you don’t want sustained contact with the person who’s sick to the point where you’re going to be able to pick this up off of surfaces or off their person and then touch your face. So what people are recommending is that if you’re able,  have the person in a separate room.

If you’re able, have the person who’s sick have their own bathroom. If the person has to come out and interact with people in the family, this is a perfect indication for one medical mask and the reason is you want to put the mask on the person who is sick. And so if in our apartment if I was sick and I had to come out and interact with my family before I would leave the bedroom, I would wash my hands, I would put on a mask, and then I would sit down and eat food at the table and then after that when I was done I would eat the food, I put it in the sink and make sure that anything I touched which is a very simple area on the table, is just washed and then I’ll go back to my room. The point is to not have sustained contact with someone in your home who has this disease. You’re gonna want to take care of them, you’re gonna want to be in and out of there, checking their temperature. Don’t do it!

Who should go to the hospital?

If you’re feeling short of breath come to the hospital. That is the rule that is the clearest thing.

It’s not “I have a fever.”  It’s not “I think I have Covid-19”. It’s not “I can’t stop having these body aches.” It’s “I feel short of breath when I get up to go to the bathroom.”

Those are people that should come to the hospital and be evaluated. At Cornell right now what we’re doing is a lot of the people that come to the emergency room, we’re sending home to live out the four or five days of their disease so that they can feel better. We say “oh you look completely fine,  go home.”

But we’re also seeing is that people who feel short of breath who come to the hospital some of them go on to the floor and just are short of breath for five to six, or seven days and then they go home. So of the entire population of people who get Covid-19 about 10% need to go to the hospital because they get short of breath.

Of the 10% who are coming to the hospital about one to three percent of those are requiring admission to the ICU and should be put on the ventilator. So what happens when people get put on ventilators? The vast majority of people, the overwhelming majority of people come off the ventilator and they usually come off the ventilator seven to ten days later, but I think the important thing for you guys to know is going to the hospital is not a death sentence. It’s a safe place for you to be. Go to the hospital when you’re short of breath. Don’t go to the hospital because you have Covid-19.

We are wondering being in a city as it really safe to go on a run or walk taking in the social distancing measures? 

Amazing question. Yes, please. If you’re in a city, you can go outside just follow the rules. When you go outside Purell your hands. When you’re going to press the elevator button, Purell your hands. When you touch the door Purell your hands, don’t touch your face. When you’re out walking in the city and don’t come within three to six feet of people. But say hello smile no one is giving each other this disease by walking through a city. If there’s a bike path you can walk on it, the only caveat is just don’t get sloppy don’t you know the problem with telling people they can do things is that everyone just assumes their old lifestyle. That is not what I’m saying, I’m saying it’s safe in New York City,  in Philadelphia to go on a walk,  just follow the rules.

If you become sick how long should you wait before you go to the doctor or hospital?

So I think we loosely addressed it, but I’ll directly address it. Which is,  don’t go to the doctor, don’t go to the hospital. The only rule for going to the hospital is if you’re short of breath.

What is amazing now is the during the Covid-19 outbreak is the use of telehealth and so by far if you feel sick and you are a little nervous or contact your health care provider by telehealth, and they will tell you that you have nothing or that you have Covid-19 and you should stay home. So do not go to the doctor do not go to the hospital.

I would encourage you to use telemedicine which is completely rampant right now because we have a ton of doctors who are at home and we’ll take your call over the internet.

If you are unaware you have the virus during the incubation period, can you infect other people?

Yes, I think that the answer is yes, and so this comes from the cruise ship data. I think there was a concern, a big concern about the asymptomatic spread,  meaning people who never have symptoms of the disease spreading it to people who then get the disease. What we know from the cruise ship data is that that asymptomatic spread it turns out that most of the people who received the virus from someone else, the person who they received the virus from becomes symptomatic in one to two days.

So it’s likely that people who get this disease are shedding the disease one to two days before they have fever So what does that mean practically? It means that if you develop Covid-19 and have a fever, know who the people are in your life that you interacted with over the prior two to three days and let them know.  Because then they can do they can follow the rules they can isolate themselves in their house, they can create a separate bathroom and then after two to three to four days if they’re not feeling symptoms, they’re probably not going to have Covid disease. So the simple answer to your question that is yes,  people transmit this disease but I do not believe that there’s this whole group of people out there who are giving this disease to everyone, and they themselves are truly asymptomatic, and they never develop symptoms. Most will get sick a few days later.

Are people becoming immune after they recover?

Yes, people are absolutely becoming immune. The stories you’re hearing about people having rebound symptoms is usually the fact that they just haven’t fully resolved the disease. So let me say that more clearly so we know that from a day or two before you have the disease until about 14 days into the disease that you’re spreading the disease to the environment.

 

Full Transcript Here: Edited Transcript of Dr. David Price video, “Empowering and protecting your family during the Covid-19 pandemic”

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Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.

Listening Effectively to Strong Emotions

Listening effectively is hard. Especially when the other person has strong negative emotions. We usually and intuitively do the wrong things.

Let me give you a quick test.

Which of the following is a better response?

Speaker: I’m so depressed about being passed over for a promotion at work. I’m worried that I’m going to be fired, or just that I’ll never get another promotion.

Listener:

  1. Cheer up, it’s not that bad. You still have a job and I’m sure eventually you’ll get promoted.
  2. Wow, that sounds really upsetting. It makes sense that you’re feeling down. Being passed over is a huge disappointment. And it also sounds like you’re worried about the future and your job. Tell me more.

Which do you think is a better response? If you picked a) then you are in good company. Most people think that that’s a better response. It’s a response that attempts to change the person’s emotion to a positive one. What’s wrong with this?

What’s wrong with it is that it is based on what I call the switch-on-the-forehead model of human emotion. In this model, we imagine that there’s a switch panel on our forehead that controls all of our negative emotions. If you feel depressed,  just reach up and flip the depressed switch to the off position. If you feel anxious, do the same with the anxiety switch. I’ve written quite a bit about depression and anxiety in previous posts, and this model of negative emotion doesn’t really work. 

Emotional Toggle Switches

Too bad we don’t have one of these on our forehead! Instead, we need to listen effectively to strong emotions.

Unfortunately, human beings don’t actually have an emotional switch panel. In reality, we are really bad at changing our feelings quickly. When someone we are talking to implies we should be able to switch off our negative emotion we end up feeling the original painful negative emotion as well as an additional layer of shame that we can’t control.

We say things like “I feel so weak that I can’t overcome my depression.” “I’m such a loser to get so anxious about a job interview.” “I should not get so angry.” Notice that all of these statements are trying to negate a strong emotion and shame comes with failing to do so.

It gets worse. There’s actually quite a bit of research on thought suppression and what this research has found is what I call the pink elephant effect. The more you try not to think or feel something the stronger those thoughts and feelings become. Try not to think of a pink elephant and if you try hard enough that will be all you can think about. This is also true of anxiety, anger, sadness, and virtually all negative emotions. Thus when we try to “cheer up” someone who is upset, it usually backfires.

Why do people use invalidating listening responses instead of listening effectively? It’s not out of malevolence. We all want to help. But these attempts to “cheer up” people are usually doomed to failure. People typically push back against the “cheer up” message. If you tell a depressed person to look at the positives in their life, they will push back and tell you about all the negatives, or they will negate the positives. Tell an anxious person that their fears are overblown and they will tell you why their fears are realistic. As they push back, they feel more depressed and more anxious.

What Not to Do When Listening to Emotions

What are the most common “try not to think of the pink elephant” invalidating listening responses?  Why are they unhelpful?

1. Simple negation statements: “Don’t feel sad, don’t feel anxious, don’t feel angry.” These are statements that simply instruct the person to stop feeling the negative emotion. Another version of a negation statement is “cheer up”, “don’t worry”, or “chill out.” Or perhaps the worst of all, “Get over it!”

These are unhelpful because we don’t have that switch panel on her forehead that allows us to simply turn off negative emotions. In fact, because throughout human history negative emotions had more survival value than positive emotions, the brain overweighs negative emotions. On the ancient savanna, fear of being eaten by a lion when you hear rustling in the brush is a survival mechanism. Dismissing this fear could lead to disaster.

2. Problem-solving suggestions: “Maybe you should look for a different job.” “Have you considered ending your marriage or relationship?”

The problem with these kinds of suggestions is that they implicitly dismiss the person’s right to have negative emotions. They suggest a simple solution that will remove the negative emotions. But they are disrespectful because most people have already thought through all of these simple solutions and either they’re not simple, or they’re not solutions that they are willing to take.

Sometimes problem-solving is reasonable, but is best done after lengthy supportive listening. And usually, it’s best to avoid problem-solving and advice-giving entirely. 

3. Look-on-the-bright-side statements: “It’s not that bad, at least you have your health (money, relationship, kids, etc.)” or my favorite one, “At least it’s not cancer.”

These kinds of statements are not helpful because typically they are experienced as dismissive of our right to have these negative feelings. And we often push back and point out that there is no bright side, which can end up in a struggle between ourselves and the listener. This struggle is frustrating for both.

4. Changing the topic entirely: “Let’s not talk about your depression, what are you doing the rest of the week?”

Again, this is usually experienced as dismissive and unsupportive. It’s like saying to the person, “Shut up and stop talking about your suffering.”

5. Get therapy or go on medication suggestions. This is when your friend or family member suggests you may need therapy or medication to deal with your negative emotions. Again, this comes from a helpful place but is often experienced as dismissive. It’s like saying, “I can’t deal with your negative vibe, so please talk to somebody else.”

There are certainly times when it’s appropriate to recommend therapy, but this is best done after using positive listening approaches. Doing it at the front end is another way of invalidating the person’s feelings.

How to Listen Effectively to Strong Emotions

If these are all examples of what not to do, what should we do when someone expresses strong emotions to us?  How should we respond? What skills can we use to listen effectively? 

1. The first step is to listen empathically. What that means is to reflect back to the person what you hear them saying particularly the emotion. This skill is called a reflection of feelings. You basically just paraphrase their emotions, making an effort to be accurate as to the intensity. If someone says I am massively depressed, you don’t reflect back “You’re feeling a little bit down.” Instead, you reflect, “You’re really feeling overwhelmingly down.”

If you accurately reflect feelings,  then the person will elaborate on what they are feeling and you reflect again. Or you ask open-ended questions like, “How did that make you feel?” or “What did you feel then?” This will also expand the responses to their emotions.

Another good option is to reflect back the emotion and then ask the person to tell you more. “Sounds like you’re really mad at your wife about her spending. Tell me more.”

Of course, basic listening guidelines apply. Make good eye contact, use head nodding and nonverbal encouragers like “mmmm”, and “go on.” And of course, turn off your phone or mute it so you can listen fully.

2. Try to avoid the temptation to problem-solve or give advice. Especially try to avoid what I call the narcissistic shift. The narcissistic shift is when you shift to your own experience instead of staying with the other person’s experience. Many people mistakenly believe that these kinds of shifts are actually empathic but they are not. Here’s an example of the narcissistic shift:

Speaker: “Ever since I went off my antidepressants I’m feeling very depressed.”

Listener: “Yes, that happened to me a few years ago. I ended up having to go back on them. That’s probably what you should do.”

Even though it may be true that the listener had a similar experience it is invalidating because typically the exact experience was quite different. Also, the message becomes, “Let’s  not talk about you, let’s talk about me.”

It is like my favorite narcissist joke. The narcissist says, “Let’s not talk about me, let’s talk about you. What do you think of me?”

3. Normalize the speaker’s emotions. Statements like, “Of course you are feeling overwhelmed, so much has been going on lately.” Or, “Of course you are feeling depressed, you lost a job you loved. It makes perfect sense.”

The benefit of normalizing emotions is that it takes away the shame. Just try not to do the narcissistic shift as part of this. Avoid saying, “when I lost my job I got depressed also.” Just remember good listening is not about you, it’s about the other person.

4. Ask questions. Open-ended questions or encouragement to talk more are the best. Examples of open-ended questions are: “What are you feeling?” “How did that affect you?” Try to avoid asking why questions as they often come across as attacking. Example: “Why are you so sad?”

John Gottman, the well-known marriage therapist, suggests some of these questions:

  • Tell me what happened.
  • Tell me everything that’s bothering/worrying you.
  • Tell me all of your concerns.
  • Tell me everything that’s led up to this.
  • Help me understand more about what you’re feeling.
  • What set off these feelings?
  • What’s the thing that’s worrying you the most?
  • What’s the worst that could happen?

Notice that all of these encourage the person to feel safe venting and talking about their most painful emotions.

Some final thoughts on Listening Effectively  

Listening effectively is simple but very hard. Most of us will have a strong temptation to do all of the wrong things when confronted with strong emotion in another person. Fundamentally, we are all uncomfortable with strong negative emotions both in ourselves and in other people. It is a hard practice to learn to accept and tolerate negative emotions in others and in ourselves.

Now you’re probably thinking about a friend or family member who tends to ruminate about things and wondering if this approach would actually be counterproductive with them. I tend to think that much rumination is actually an interpersonal phenomenon that is based on unsupportive listening. A good analogy, although somewhat gross, is training an abscess or boil. When it’s fully drained, a painful process, healing begins. If you just put a Band-Aid over it, it only worsens. Unsupportive listening forces the speaker into pushing back by staying stuck with their emotions rather than fully expressing them.

If you really believe that someone you care about is stuck in rumination, then do an experiment. Listen effectively and fully for an hour. Let them cry, scream, quiver, whatever they need. In most cases, they will feel better and be less stuck in rumination. And you will have given them an amazing gift of love and kindness. Try it sometime, you will be amazed at the results.

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Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.

Deep Work: How to Become More Productive using Deep Work Concepts

Over the weekend I read a fascinating book: Deep Work: Rules for Focused Success in a Distracted World* by Cal Newport.

I’ve written before about the dangers of distraction that come from our smartphones and even published a poem about it by a good friend. This book further explains why our smartphones are making us dumb and dumber.

I should preface this review by saying that this is not a fun book. The writer is a college professor and as such writes like one. I have read other nonfiction books such as Stumbling On Happiness* by Daniel Gilbert which are both profound and fun to read. This book is a bit too dry to be fun to read. Another criticism of the book is that the author uses himself as a case study of one, tying his impressive academic output to deep work. I’d have preferred more people included in the case study.

That being said this is still an important book and even more so an important concept. In this article I will explain the concept, and suggest some ways to implement it.

What is Deep Work?

What is deep work? Deep work is work that pushes your cognitive capabilities to their max and which is performed without distraction. It typically results in some sort of productive product or output, although it can also result in some new learning or new skills. Deep work takes place during long sessions of uninterrupted high intensity, focused work.

How does this compare with shallow work? Shallow work is typically logistical in nature, is not particularly cognitively challenging, and often produces little or no real output. Email is a great example of shallow work. Reshuffling your to do list is another example.

Although the author doesn’t make this distinction, I would add two more categories which would be shallow play and deep play. Shallow play is all of those things we do which are basically mindless. Checking Facebook, surfing channels on TV, reading a thriller novel — all are examples of shallow play.

Deep play, in contrast, requires us to use our full set of abilities. Learning a new language, playing a musical instrument, practicing tai chi, improving one’s golf game — these are all examples of deep play.

Why is Deep Work Important?

Why is deep work important? Deep work allows you to reach your maximum cognitive capacity. It also allows you to produce extremely high-quality outputs, and to learn important and significant new skills.

The author talks about types of work and those who will thrive in the future economy. He makes the point that three types of workers will do well. One type is those people who control and own capital, such as venture capitalists. Another type is those who can work with machine learning and intelligent machines. The final type is the superstars in almost any field. It is this third group who will most benefit from learning how to do deep work. The capability for doing deep work is what distinguishes the superstar from the merely average worker.

Learning How to Do Deep Work

How can you train yourself to do more deep work?

This is a challenge. Deep work is hard! Shallow work is easy. The biggest challenge to doing deep work is that so many of the forces in our current environment push us in the direction of shallow activities. All the apps on our smartphones push us into the shallows. (With the exception of reading apps.) Email pushes us towards the shallow. Surfing the internet, looking at YouTube, Facebook, Twitter, — all of these push us towards rapidly shifting attention and shallow focus.

And since most of us work on an internet connected computer, even if we try to do deep work it’s all too easy to get distracted or to avoid by jumping to something shallow.

Worse yet, we have zero tolerance for even a few moments of boredom. What do you observe when you see people waiting in line? You see everyone looking at their phones. Nobody just stands there thinking. We have trained our brains to instantly shift to mindless activities whenever we are bored or restless, instead of thinking about the deeper issues in our lives.

Even while writing this article, there were several moments when I remembered something that I forgot to do and checked my email to see about taking care of it. Looking back on these episodes I realized that I had run into a difficult point in writing this article. Instead of staying focused, I avoided the difficulty by switching to something shallow and meaningless.

Deep Work in Action
Deep Work in Action

Avoiding Crashing in the Shallows

It is so easy to go into the shallows. Our days disappear into a haze of shallow activities. Even when we are productive, it is still all too easy to be productive in a shallow way. I will answer 10 emails — shallow. Let me check the headlines — shallow. Time to update my to-do list — shallow. Now let’s straighten up my desk — shallow. We check off to-do items with great joy even when they are completely shallow and unimportant. We forget to ask ourselves if each productive activity can really alter our world or the world at large.

The biggest challenge of deep work is training yourself and your brain to be able to achieve long periods of focused concentration. I don’t know about you, but I sometimes feel like the internet has broken my brain. It is all too easy for me to jump from website to website.

My only saving grace is that in my work as a psychologist, I have extended periods each day during which I am completely off the Internet and off my phone while working with clients. I automatically fall into a deep work mode while doing therapy. It is one of the reasons I cherish doing therapy. It is like a forced meditation into deep work.

Here is my prescription for how you can learn to do more deep work. First of all, just like any other muscle, you will have to build up your ability to do deep work. If you’re currently doing little or no deep work, then it’s probably best to aim at only doing one hour a day of deep work. Once you get used to doing that level, you can gradually increase it. Newport says that the maximum amount of deep work that anyone can really do is four hours per day. I think this is too much for most people, and a goal of two hours a day of deep work would be more reasonable.

Next you need to set up an environment which minimizes distractions.

You will need to make sure that your smart phone is muted or on airplane mode so that there are no vibrations or sounds. Even better, put your smart phone in a different room. That way you won’t be tempted to look at it. Also turn off any notifications on your computer.

Go someplace which is un-distracting. If you are at the workplace go find a conference room or other quiet space where you won’t be distracted or interrupted. If you are at home you will also need to set up or identify the least distracting space. If your deep work requires using the computer you might even want to disable the Internet temporarily.

Another trick is to have a separate computer for deep work. I have a friend who has two identical laptop computers. One has the normal complement of apps, web browsers, etc., the other laptop is his writing laptop. That one has virtually no apps, except for Microsoft Word. It doesn’t even have a web browser. On the writing laptop he has disabled the network card so that even if there is Wi-Fi, he can’t access it. Basically, that laptop is only good for one thing, writing.

(Another way to accomplish the same thing with only one laptop would be to have two separate Windows or Mac users. Your Writing User would only have the basic tools for writing, while your other user would have all your regular apps. When you are ready to write, you shift to the Writing User.)

Or just go old school. Many years ago, I got several speeding tickets in a row and had to attend two days of traffic school, back in the ancient days where you actually went to a classroom and sat there for eight hours a day. I had 16 hours of listening to a boring instructor drone on about the dangers of speeding. I sat in the back of the classroom with a large yellow pad, and I wrote about 40 pages of a book I was working on. I never could have been so focused in a normal environment. Even now, I sometimes take a pad and pen to a café or library, put on some noise blocking headphones, and handwrite something I am working on. I usually leave my phone behind or at least I power it off.

Time-Structuring Deep Work

There are several different time-structuring strategies for doing deep work.

There is the Thoreau method, where you go to a cabin in the country (preferably with no Internet), and spend several weeks to work on a project. You work, take walks, work some more.

There is the Thoreau-lite method, where you block off a day or two per week and isolate yourself someplace relatively un-distracting and work on a project.

And finally, there is the daily approach, where you set yourself a daily period of doing deep work for an hour or two. Ideally, you would do this first thing in the morning, but some people have also been successful working late at night after their families are asleep.

Mastering Your Gadgets

Some other tips that may be helpful for avoiding distractions.

Turn off all notifications on your phone. All those beeps and vibrations from multiple apps are very distracting. I recommend you turn all of them off, even text messages. If you’re worried about missing important messages, tell people that if they want to reach you urgently they should call you. You can batch your text messages just like email. Look at it before lunch and before dinner and respond accordingly.

Uninstall all of the so-called endless page apps on your phone. This includes Facebook, Instagram, Twitter, and all the other apps that require you to pull in order to refresh. You may also want to install reading apps such as Flipboard, Feedly, New York Times, etc.  On your computer, you may want to sign out of similar apps such as Twitter, Facebook, and even email. This requires you to sign in to use them which creates a small speedbump which makes you more mindful.

The key to engaging in deep work activities is spending less time doing shallow activities. We all have a finite amount of time in our days, weeks, months and years. The more time we spend shallow the less time we spend deep. Realize that the shallow is tempting, fun, and easy — but ultimately relatively unsatisfying. If you can learn to do several hours of deep work per day you will be better at whatever you do. And you’ll be better than most people who spend almost no time doing deep work.

Now that I’ve done some deep work in writing this article it’s time for a walk.

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Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.