When Jemma started a pediatric OT clinic, she needed help with computer input, filing, organization of supplies, and other basic support tasks. So she hired a college student for 15 hours a week. Mihn was an extremely bright young man, and he was eager to please. After a short time, Jemma noticed that he had a distinctive work style — and ultimately this was the reason she let him go. When given a task, Mihn did not immediately begin work. First he had to set up his “work environment,” which to Jemma’s mind meant that he reconfigured her computer to the point of nonworkability. Once it was to his liking, and every glowing box was illuminated and feeding him input, he would begin filing or typing or organizing supplies — all the while interacting with music, videos, games, text messages, and whatever else, engaged in each task simultaneously. When Jemma resumed control of her computer at the end of his marathon work sessions, random pop-ups interfered with her attempts to write treatment notes, generate reports, and even access files. She spoke with Mihn several times, asking that he focus more on his work tasks, but Mihn assured her that he was and that instant messaging did not interfere with his work. To make matters worse, when she checked his work, she discovered his final product was often incomplete or otherwise unprofessional. Was Mihn merely a poor worker, or was he a victim of the technology he so adored?

We all multitask: downloading a file while we make a quick call to schedule an appointment or searing a pork roast while we throw the laundry in the dryer. Performing multiple tasks at the same time gains us, we think, greater productivity. But like water running down the drain while we brush our teeth, precious resources escape when we try to do too much at one time: one side of the roast gets burnt to a crisp, the wool sweater mistakenly plunked in the dryer shrinks to toddler size, and the downloaded file is tucked into a nonessential folder, never to be found again. Multitasking has become glorified and glamorized as an essential skill for success, a timesaving strategy, and a sign of high intellect and stature. But multitaskers might not be reaping the benefits they think they are.

Maladaptive Habits of Multitasking

The brain needs time to consolidate, reflect, and organize thoughts and memories. Constant stimulation interrupts that essential need, causing poor ability to organize and retrieve knowledge later. When the brain multitasks, cognitive processes are impaired, and individuals lose the ability to engage in deep or reflective thought. The more they multitask, the worse they get at multitasking,¹ and overexcitement impairs their ability to concentrate, filter out irrelevant information, and switch from one task to another in a timely manner.²

When we switch from one task to another, our performance degrades both in accuracy and in speed (response time). Response time is a brisk area of study for cognitive scientists,³ who have consistently demonstrated that reaction times vary proportionally with both the number of elements presented and the cognitive process of searching and reacting. They also have found that multitasking involves serial (instead of parallel) processing only. Further, people who do a lot of multitasking seem to become addicted to information seeking; their greatest thrill is to get more, and they are especially pulled to irrelevant, extraneous information.¹ They can’t use, organize, or take in information effectively, and perhaps more provocative, they take longer to complete tasks than those who monotask, even when they are not multitasking! They also make more errors.¹

A media-rich, multitasking workstyle is consistent with the generation born between 1982 and 2000. This cyber-savvy group expects instant access to all knowledge and is globally connected to the other 76 million in Generation M. As a consequence, their environment must be aglow with novel input from multiple ports for them to feel ready to work. Some say this generation is addicted to novelty, that they have difficulty focusing on one activity, and that they have wired their minds to be in a perpetual, hyperkinetic state.^4,5 Others say they are wizards at filtering through volumes of information with ease.⁶

Meanwhile, those born from 1946 to 1964 value overtime, accept the need to be overcommitted, and are competitive out of necessity. They struggle to understand the failure to complete tasks and inattention to quality of work. In work settings, newly hired Gen Ms are texting during treatment sessions and staff meetings, without regard to the impression it makes to those outside of their generation. Gen Ms’ habits drive baby boomers crazy. At the same time, baby boomers lust for their multitasking abilities as they text and IM and download podcasts into their iPhones, thinking it would help them accomplish their goal of being more productive. Is it multitasking or is it adept technological skills? The two are considered synonymous — and maybe they are, but maybe they aren’t. This conundrum brings up many questions about productive work habits, routines of efficiency, and ritualistic behaviors that impede our ability to find balance and restoration in our daily lives.

Some fear that as millennials use technology to multitask in more and more domains of their lives, their ability to focus and sustain attention on one thing is becoming diminished.¹ Research in cognitive psychology has shown that each time the brain has to switch tasks, there is a cost in terms of time, working memory resources, and accuracy.⁷ This research seems to imply that if we have several tasks to accomplish, we are actually better off if we work on each one sequentially, in a serial pattern, thus minimizing the number of times we ask our brain to switch tasks.

The act of dividing our attention affects our ability to learn, problem solve, interact socially, and ultimately understand our world. Cognitive scientists are concerned that this trend is creating a frenzied need to be stimulated by input and an inability to relax and accept mental downtime.⁸ In a sense, the future success of an entire generation is at stake. When a habit sets in motion a series of unintended but costly outcomes, we need to give it our attention. Unending, relentless intrusions add up to an average of 2.1 lost hours per day. And returning to on-task behaviors can take 10 to 20 times longer than the interruption itself, costing the U.S. economy $650 billion per annum in unnecessary interruptions and recovery time.⁹

Sirens on the Banks of Productivity

Whether multitasking is a skill to cultivate and pursue in earnest or a disorder of logical thought that costs us more than we gain, the allure is undeniable. In ancient myths, sailors were lured to their deaths as they followed the Sirens’ bewitching songs. Perhaps we should first understand the seduction of multitasking and societal and cultural influences that have led to an increase in multitasking before considering a new course.

From the beginning of industrialization, workers have watched as machines did twice as much work in half the time as any mortal could. But never before has technology enabled us to juggle so many balls at the same time. Portable technologies like cell phones, PDAs, iPods, and laptops allow us to take our conversations, music, videos, calendars, and projects with us no matter where we are. Such behavior would have been impossible in previous generations. We’ve lived through downsizing and layoffs and furloughs and shortages in healthcare. And we are still asked to do more with less. As we are pressed to be more productive, the allure of multitasking calls to us with a promising cyber glow.

In general, today’s culture values those who multitask more highly than those who do one thing at a time. Multitasking is considered an “executive function”; those who only attend to one thing are sometimes put down as mere “worker bees.” Indeed, the ability to accurately and effectively perform multiple tasks in a timed situation is the Holy Grail of both academic and professional success. This expression of executive function is one of the most prominent neuropsychologic theories of attention and learning.^10,11 However, the area of the brain used for this skill, the prefrontal cortex, has yet to mature in 20 year olds (the Gen Ms) and is the first to erode with aging.

To an extent, we can get better at doing two things at once if we practice splitting our focus or shifting our attention rapidly. But we need to discriminate when to use the skill, when to clear the desk and focus, and when to rest. When performing highly demanding cognitive tasks, we must also acknowledge that frequent breaks are needed to avoid burnout and fatigue. It is faulty logic to think sustained effort at this level can be persistently maintained. Recent research has dispelled two key myths of multitasking:

1. Those who multitask a lot are better at it.
2. Multitasking is a way to increase productivity.⁴

For example, an OT skilled at making a splint can easily drape the warmed thermoplastic over the client’s hand and immobilize the thumb while explaining how to make traditional Maryland crab cakes. Researchers have found this takes more time and chips off the game clock nanosecond by nanosecond.⁷ While this rapid shifting of attention may cost us a bit of time, we would probably say the payoff — putting the client at ease and building a relationship — is worth the cost. But if a task isn’t second nature, the brain has to hyper-focus on one aspect at a time. In fact, all we get good at is switching back and forth more rapidly so it looks like we’re doing more than one task; we’re not. But there’s little cost, and the smooth pursuit of each task gives us the false impression we can continue that habit with more complex acts. The newer the task or the greater the complexity, the less smoothly we can shift, and the more brainpower we extend to maintain the illusion of simultaneity.

We can only effectively “multitask” with habituated, routine, procedural tasks because we can rapidly shift between familiar tasks with alacrity. But there is a cost to the perceived increase in productivity. This skilled part of multitasking can be learned, but the cognitive part cannot. The truth is, cognitively, we cannot do more than one thing at a time.¹²

Recent research has begun to untangle the controversy of multitasking and productivity by exploring how the brain functions when performing multiple tasks.⁷ The executive control process seems to have two stages: goal shifting and rule activation. During goal shifting, the brain quickly prioritizes tasks and executes a response to attend to the higher priority. During rule activation, the brain seems to turn off the list of procedural steps, or rules, associated with the first task and turn on the step-by-step playbook for the new task. This second step, rule activation, takes time away from overall performance. Granted these microseconds are brief, but they add up during the course of a day and are detrimental to the performance of a task. At a minimum, multitasking costs time and stress. At the extreme, it can result in injury or even death. We don’t have to think long to conjure up a story about someone failing to make a critical, split-second decision, which resulted in tragedy.

To successfully multitask, like all aspects of executive function, we must learn to prioritize, delegate, and shift from one task to the other; we must also know when to give a task our full attention and when to self-monitor to offset the costs of multitasking. We perform high cognitive skills in short bursts and then need periods of rest. We need to take these rests, take the time to be mindful and focused on one task. And we have to identify the right problem, solve it, shift to the next problem, solve it, and triage the highest needs of the organization in that fashion, monotasking along the way. When working with children, some OTs play “stop, change, start” games to teach this skill. And saying, “Stop, change, pause to breathe, start,” can help healthcare workers remain mindful throughout the day.

The Myth of Multitasking

The mind can only hold on to one thought at a time, but attention can be quickly shifted back and forth and focused on multiple inputs.¹² Procedural tasks can be performed simultaneously in limited numbers. But we need to consciously and deliberately identify when multitasking is an appropriate choice. We wouldn’t want a physician texting while performing surgery or an OT chatting on the phone while a child was perched precariously in the upper corners of a cargo net. When we are multitasking, we are not fully attending to any one task. We may be able to smoothly shift sets for a while but not for a sustained period of time and not without a cost. Planning an action, such as responding to someone calling for help, is performed exclusively sequentially. The higher the cognitive load, the more complex or novel the task, the more units of energy it requires from us to execute.

When we are multitasking, we are asking our brains to rapidly and frequently switch tasks. The analogy with modern computers is frequently drawn. A computer central processing unit can only run one program at a time (like a human brain). If the CPU needs to run multiple programs, it prioritizes to perform the tasks in rapid series. Each computer program has its own needs in terms of working memory and input/output devices, such as network connections, printers, speakers, keyboard, and mouse. The brain seems to have a finite working memory capacity similar to a computer. To expand the analogy, a newer computer (and often a younger mind) can hold more units of input at the same time, shifting effortlessly amongst them. Input devices for the brain are our sensory organs, bringing in music, visual IM pop-up windows, and more. We use sensation to alert us (hot coffee … must have hot coffee) so we can shift our attention back to a challenging task (… and what were you saying about this year’s taxes, dear?).

In some cases, when the number of tasks is small and the resource demands are manageable, multitasking appears to work in smooth, simultaneous layers for both computers and brains. But if the number of tasks gets too large, or if some of the tasks are demanding, performance can degrade dramatically, for both computers and people. Computers, however, cannot evaluate the potential cost of an error and determine if the risk is too great before freezing, shutting down, or creating an error.

In the space of a generation, the number of hours Americans work each week has increased by 8% percent to an average of 47 with an estimated 20% of the Americans in the workforce working 49 hours a week.¹³ Those who multitask take longer to accomplish tasks than those who monotask¹ — as much as twice as long.¹⁰ Daily attention to e-mails, IMs, texts, and other interruptions are costing us millions of dollars in lack of productivity.⁸

Strategies to Improve Performance

Now that we are aware of some of the costs of multitasking, one approach is to try to reduce the number of task switches performed in a day. In other words, try to carve out periods in which to “monotask,” while being mindful of the level of complexity involved in a project in which you rapidly shift back and forth in a “multitasking” manner.

Some researchers suggest that multitasking is a learned skill that improves with practice,⁴ but more current research disputes that. Some people feel they can start out with a few fairly routine tasks and after some practice at this level, gradually increase the number and complexity of the tasks until they reach the level required to complete the job. But be mindful that this only applies to routine, procedural tasks in the best circumstances (like making coffee while watching a contained toddler). Researchers suggest that women are better able to perform multiple procedural tasks than men.¹⁴ Nevertheless, attending to one thing at a time will help you accomplish more and feel more rested at the end of the day, and it will leave you with richer interpersonal experiences.

Here are some suggestions for becoming effective at moving from mindless multitasking to mindfulness throughout the day. Most of us won’t be able to jump from multitasking to monotasking, but we can try to be more mindful in moments during our day.