Recommendations
Monday, January 29, 2024
Brooks, Placebo Article
Thursday, January 4, 2024
Tressie McMillan Cottom
Oct. 9, 2023
We have become fluent in the new language of pharmacology, diabetes, and weight loss. Ozempic, Wegovy and Mounjaro are part of our public lexicon. Glucagon-like peptide-1 (GLP-1) receptor agonists are lifesaving drugs, created to help the hundreds of millions of people with Type 2 diabetes and clinical obesity. They promise to rid the United States of obesity, if our country can figure out how to make the pricey fix affordable.
But these wonder drugs are also a shorthand for our coded language of shame, stigma, status and bias around fatness. Untangling those two functions is a social problem that one miracle drug cannot fix.
It is hard to recall the last time a drug so excited the general public. Fen-phen in the 1990s, maybe? Viagra or Botox in the 2000s? Each had amazing hype cycles but none as explosive as Ozempic. Market watchers have flagged Novo Nordisk, the Danish pharmaceutical giant that makes Ozempic and Wegovy, as a contender for most valuable company in Europe. With better drugs still in various stages of development, the anti-obesity gold rush has just begun.
If GLP-1 drugs only treated diabetes and did not promote weight loss, they would still be medically groundbreaking. But Ozempic, Wegovy and Mounjaro probably would not have social media hashtags. These drugs are blockbusters because they promise to solve a medical problem that is also a cultural problem — how to cure the moral crisis of fat bodies that refuse to get and stay thin.
That many people don’t even question that eliminating fat people is an objectively good idea is why it is such a powerful idea. Thinness is a way to perform moral discipline, even if one pursues it through morally ambiguous means. Subconsciously, consciously, politically, economically and culturally, obesity signals moral laxity.
Any decent cleric will tell you that there is no price too high for salvation, so an entire class of people — the roughly three in four adult Americans who are overweight — is a target for profit-seeking. Medical weight loss interventions have, over the years, led to heart damage, strokes, nerve damage, psychosis and death. But under this moral code, it’s the social policies that promote, subsidize and profit from obesity that are cleansed of their extractive sins. It’s as if fat bodies, by housing slovenly people, do not deserve the protections of good regulations and healthy communities.
There’s something seductive about a weekly shot that fixes the body while skipping right past the messiness of improving the way people have to live. Both diabetes and obesity are conditions that are as much about social policy as they are about what people eat. Studies show that the crops the U.S. government subsidizes are linked to the high-sugar, high-calorie diets that put Americans at risk for abdominal fat, weight gain and high cholesterol. Sprawling communities, car-centered lives and desk jobs make it hard for many Americans to move as much as medical guidance thinks that we should. Under these conditions, telling people to change their lifestyle to lose weight or prevent diabetes is cruel.
It should be no surprise that near-guaranteed weight loss — big, rapid weight loss in many cases — drives millions of people to take the drugs off label, creating consumer demand like the gold nugget that lured miners out West.
The cultural conversation around Ozempic is as obsessed with celebrities as the celebrities are obsessed with themselves. Rumors of which A-list star was on Ozempic peaked with the pejorative “Ozempic face,” a sign that someone was taking a shortcut right to skinny’s spoils. Social media users became adept at finding clues that a celebrity cheated, purchasing obesity absolution through pharma indulgence.
At the top of the status hierarchy, the rich, famous and near famous were getting skinnier. But in the same span of years Ozempic took hold of those buzzy sets, I began noticing that regular people like my friends were being reclassified as insulin-sensitive, insulin-resistant, and the utterly terrifying “prediabetic.”
Most of them are highly educated, self-made successes, with no family wealth or other cultural endowments. They handle their health with the same ferocity they brought to college admissions and career planning. One friend began blowing into a device that told her if she had reached a “fasting” state; another was prescribed metformin, a diabetes medication. So many of them seemed to be on a crash course with a medical liminal state that associated them with diabetes even though none of them were diabetic.
Although it was unknown to me at the time, my friends were swimming with a public health tide that would mark them for medicalization, even though nothing about their physiology, behavior or medical profile had changed. They may have needed drugs, they may not have, but “prediabetes” is not a precise enough predictor of whether anyone will become diabetic to warrant the fear the term provokes.
The American Diabetes Association developed the term “prediabetes” to bring attention to slightly elevated blood sugar levels in some Americans in 2001. Over the next two decades, the organization expanded the definition of the condition, so that by 2019, as Charles Piller reported for Science magazine, 84 million Americans had prediabetes, “the most common chronic disease after obesity.”
There were no drugs specifically designed for prediabetes, so doctors often relied on off-label treatments, a common medical practice. But because off-label drug interventions coincided with the wholesale expanded classification of millions of people with a novel condition, a new market boomed.
This shift broadened the consumer language for medicalizing weight loss as a preventive strategy to treat not only diabetes, but also supposed — though not always proven — diabetes risk. It armed a wellness machine with the medical terminology of “insulin resistance” and “insulin sensitivity,” without the medical expertise to screen for diabetes risk indicators. People could soon buy an astonishing array of apps and devices to self-diagnose insulin efficiency. Enter Ozempic and Wegovy, perfectly designed for our highly developed consumer palates.
Given all these changes, I wondered what Dr. Richard Kahn, the former chief scientific and medical officer at the American Diabetes Association, who helped establish “prediabetes” as a term, now thought about the phenomenon.
When we talked, Dr. Kahn told me that he regretted his role in developing “prediabetes” and its associated grift, but his giddiness about GLP-1 drugs was palpable. He said that encouraging weight loss through lifestyle changes was an “abject failure.” Now, Ozempic offers patients light and hope.
The problem with these drugs, he said, “is that they cost an enormous amount of money.”
Ozempic and all similar formulations are administered by injection, via a pen that lasts about 30 days and costs from about $900 to $1,300. A year of pens can run from $10,000 to $16,000; the median household income in the United States is around $75,000. How in the world can regular people afford it?
It’s easy to assume that the non-wealthy use health insurance to pay for these drugs. And yes, if they’re using Ozempic for diabetes, the health insurance claim is straightforward. But for weight loss, getting health insurance to pay for Wegovy (or even Ozempic) can be more difficult. As Dr. Kahn says, “The vast majority of insurance companies refuse to pay for it no matter what the degree of obesity is.”
Dr. Kahn grasps the big picture of health economics and the insurance cliff we’re standing on. But in the doctor’s office, the cliff is more of a canyon. In 2021, I went to a fancy doctor for my annual checkup. I justify the steep subscription fee for my concierge medical care because I have moderate medical anxiety from years of being talked down to, ignored, dismissed, and victimized by medical malpractice. I consider the concierge fee a convenience tax to be treated like a person.
After two hours of getting to know my new OB-GYN, bloodletting, and internal spelunking, we sat down to talk about my lifestyle and health goals. As an overweight person with high verbal acuity, I was sure to describe my Peloton practice as well as my plan to eat more plants for ethical reasons. The doctor’s face lit up when I finally intimated an interest in, shall we say, size modification.
Glancing at my blood test results she began describing her professional interest in “metabolic medicine.” What followed was a 20-minute presentation on the advancements in weight loss drugs. Ozempic was the star, but there were other drugs, many of them prescribed off label. The seizure medication might curb snacking. Another might slow digestion if it did not ruin your kidneys. And then, of course, there were the “injectables,” the “gold standard” of weight loss medical interventions.
The only problem was that I was not diabetic.
I was not even medically prediabetic.
The doctor said this with great regret.
My A1C, the measurement of average blood sugar levels over the past months, was within the normal range. It was, in fact, bordering on low.
“But these tests malfunction. We can test it again,” she said hopefully.
My doctor was hoping for a higher A1C because it would classify me as prediabetic and would increase the odds of getting health insurance to pay for the off-label use of the pricey drugs she recommended to me that day.
I vacillated between wanting to show my doctor that I could afford to pay for Ozempic out of pocket, not even wanting Ozempic and wanting to prove to her that my A1C was no fluke. I took the A1C test again a week later. It was still low. She was still dismayed.
I switched doctors when I realized one of us was rooting for me to be sicker so I could afford to be skinnier. In her defense, that is exactly the equation that GLP-1 drugs present to the millions of Americans who need health insurance to afford them.
Of course, that says nothing of the 27 million Americans who do not have health insurance at all. People without insurance are typically low-income and are overexposed to the social policies that produced the obesity crisis. For them, the best-in-class drugs may as well not exist.
But, just for the sake of argument, if obesity is a public health crisis and it can be solved with one imperfect injectable, it should be possible to make it so that everyone can afford the solution.
But so far we have done the opposite. To prescribe millions of Americans Ozempic at its current price would stress the health care system to its breaking point. Dr. Kahn did some rough math when we spoke. “If 80 percent of the people with obesity would start to take this drug,” he argued, “it would bankrupt the health care system.” He bases that on the Centers for Disease Control and Prevention’s finding that more than 40 percent of Americans are obese. “We’re hurtling quite rapidly to this game of chicken,” Dr. Kahn said, “where you have the manufacturers saying they’re not going to reduce the price. And you have the insurance companies saying it’s too much to pay.”
Making GLP-1 drugs accessible for Type 2 diabetes and weight loss at a cost that regular Americans could afford would be an achievement for our health care system. The Biden administration is rolling out its Medicare Drug Price Negotiation program. For now, none of these drugs are included. The Treat and Reduce Obesity Act would expand Medicare coverage for obesity. These are the kind of policy approaches that could be a game changer for obesity management and diabetes care while this country continues to work on the bigger problem: our poverty of imagination for the ethical care of all bodies.
For now, cash-strapped American consumers are left to contend with a society in which the price of being fat is so high that there will always be a rational reason to pay an exorbitant amount to be thin.
There is weight loss for health. There is also weight loss for status and avoiding stigma. While both men and women experience greater discrimination if they are fat, women suffer more for failing to be thin enough. Study after study shows that overweight women are more likely to be unemployed than their thinner counterparts. When they are employed, larger women earn less, with smaller penalties for Black and Hispanic women, who already earn less, on average. Overweight white and Asian women experience the labor market discrimination that Black and Hispanic women already do.
Outside of the workplace, the trend of educational and economic elites marrying, befriending and socializing with one another — assortative matching and mating — is also a marked characteristic of our time. Elite homogeneity has a look, and the look is thin. So when women say that it is better to be sick and thin than healthy and fat, they are perfectly rational.
Kate Manne, a philosopher, says that the fear of being fat — fatphobia — is structural and intersectional. In her forthcoming book, “Unshrinking,” she questions whether solving obesity is something that can truly be done by eradicating fat people. Ozempic mania is not just a perfect example of how self-defeating our health economics are in this country, as Dr. Kahn points out. It is also an example of how the American penchant for solving structural issues by fixing individual bodies is excellent at creating demand without solving social problems.
I was overweight before I entered the concierge medical office. But being overweight was incongruent with a person who could afford concierge medicine. My doctor assumed I would want to be thin. In many ways, she was providing exactly the service I didn’t realize I was paying for — acculturating me to the expectations of the right body for my station. Minimizing weight stigma was a health service, even if my health indicators did not require intervention.
The mere existence of Ozempic and the like encourages millions of people to self-diagnose in a way that stigmatizes. If they walk into doctors’ offices begging to be classified as medically vulnerable, it’s not for some provision from the state like housing or food. They want a drug that can help them manage an environment that works against their aspirations. That is a condemnation of our culture.
Ozempic’s implicit promise is that it can fix what our culture has broken. There aren’t breathless profiles of a pharmaceutical drug because it will help a diabetic manage her blood glucose level. They exist because it promises to democratize access to the holy grail of embodied privilege, that sexy sexism of “nothing tastes as good as skinny feels.”
Whether fatness is a problem for the millions of people whom these drugs are poised to leave behind depends on perspective. It’s perfectly normal to live a happy, full life in a body that is above the medically recommended healthy size. Plenty of people do it and have done it. But being overweight becomes a social problem when it’s a population level statistic with a status hierarchy attached.
When supply chain disruptions made it harder for diabetic patients to get Ozempic last year, wealthy people bought the drug at a premium for weight loss while people who needed it struggled to fill their prescriptions. Then, the grim picture of inequality was clear.
But as the supply rebounds, the inequality may get harder to see. That would be unfortunate.
Inequality of access to Ozempic and Wegovy is not between the deserving sick and undeserving obese. The inequality is in attaching any moral clause to why people use the drugs in the first place. As long as most Americans cannot afford the drug that democratizes weight, the stigma of obesity is still controlled by those who can afford to be thin. GLP-1 drugs — or any miracle drug that cures obesity on label or off — works only if people who need the drug can afford it.
But solving for obesity will require more than drugs. It will require solving for a culture that makes being fat a woman’s burden, a means test for dignity, work, social status, and moral citizenry.
Until we end that stigma, we can create drugs that help people lose weight, but the conditions for making some people undesirable — at a cost — will still be lurking in the shadows.
Tressie McMillan Cottom (@tressiemcphd) became a New York Times Opinion columnist in 2022. She is an associate professor at the University of North Carolina at Chapel Hill School of Information and Library Science, the author of “Thick: And Other Essays” and a 2020 MacArthur fellow.
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A version of this article appears in print on Oct. 15, 2023, Section SR, Page 10 of the New York edition with the headline: Ozempic Can’t Fix What Our Culture Has Broken. Order Reprints | Today’s Paper | Subscribe Culture, economic sociology, inequality and digital life.
Monday, January 1, 2024
Thursday, October 12, 2023
Saturday, October 7, 2023
FOUNDATIONAL PRACTICES IN THE INTEGRAL YOGA OF SRI AUROBINDO AND MIRRA ALFASSA
PART 1: INTIMATIONS OF OUR ESSENTIAL NATURE
(NOTE – This is part of a series I’m writing on “Integral Yoga in Everyday Language.” While this is somewhat more complex than the previous essays, the practice, “Space of Awareness,” is easily accessible even to those with no prior familiarity with yogic philosophy or practice. Please read it very slowly, with long pauses between sentences – and allow the experience to which it is pointing to unfold slowly, easefully and with much quiet, peace and deep stillness)
THE VIEW FROM INFINITY
Intimations of Infinity
While India – the home of yogic psychology – has always placed great value on intellectual understanding, the yogic tradition takes direct spiritual experience to be the foundation for any valid intellectual view. the spiritual experience at the core of the Indian tradition has been described as the experience of an infinite Consciousness, an infinite Being in whom the entire universe has its existence.i But it is important to remember that the description of the vision is not itself a “view from infinity” – that is, the direct “knowing” of that Reality. It is meant only to be a pointer to an experience or way of knowing which cannot be captured in words.
This experience – perhaps more correctly referred to as a recognition – provides a means of a radical transformation in our own body and mind, and potentially, a transformation in the very root of how we understand the universe. Having “attained” this recognition, we can learn to bring attention to the various workings of the Infinite Being throughout the universe, and to provide intimations of Its Presence here and now, in our every thought, feeling and sensation, every rock, plant and animal in our environment, and each person we encounter. The various streams of the yoga tradition are one in their agreement that the ordinary human mind is not capable of perceiving the Infinite. However, yogis of all traditions have always made use of words to evoke something beyond the mind, to open a window onto the richness, beauty and vastness of that Reality which is the very substance of all we experience.
While the Indian spiritual tradition has perhaps been the one to speak most openly of the all- pervasive, all-embracing nature of the Infinite Divine Being, all spiritual teachigns have – at least at their mystic core – pointers to this experience.
In the New Testament, St. Paul describes God at that “in whom we live and move and have our being.”ii In the Koran, Allah is referred to as being closer to us than life itself, closer than “the jugular vein.” In the Hebrew Bible, God, speaking to Moses, gives His name as “I Am That I Am.”iii Native American and other indigenous peoples recognize Spirit to be present and active throughout the universe.
Jewish scholar Abraham Heschel describes a state of mind that can make the experience of this greater Reality more accessible. He suggests cultivating an attitude of awe which is “itself an act of insight into a meaning greater than ourselves... [enabling] us to perceive in the world intimations of the Divine... to sense the ultimate in the common and the simple; to feel in the rush of the passing the stillness of the eternal.”iv
But how can we cultivate an attitude of awe? For some, a “thinning of the veil” which opens us to the sense of awe can occur in communion with the power and beauty of nature: listening to the gentle, unearthly silence of a large metropolis blanketed in snow... watching the play of light dancing on the wind-swept surface of Lake Geneva... walking down Fifth Avenue in the hush of twilight, lost in thought, suddenly catching sight of the deep orange sunlight setting fire to skyscraper windows. The awesome quality of these experiences tends, to some extent, to calm the disjointed play of our ordinary thought, bringing about an openness and tranquility that allows for something deeper to emerge from within.
Literature, painting, dance, theatre, cinema, and religious ritual have all, since prehistoric times, been at heart, a means of softening the boundaries of our ordinary awareness, thus helping us to experience something that transcends our limited selves. In the solemn intonation of a priest’s chanting of a sacred text, our hearts softened, our minds stilled, we feel a mysterious Presence spreading throughout the cathedral... we are transported with Sri Aurobindo’s Savitri, as she voyages “through worlds of splendor and of calm”v ... in a darkened theater, we face death with Sir Thomas More, at peace in the noble equanimity of a high ideal.
The various practices of the yoga tradition are designed to make it possible for us to enter into this deeper experience at will, without need for external triggers. Ultimately these practices can help to dissolve the filmy screen altogether so that the “stillness of the eternal,” the soft and luminous presence of the Infinite is always and everywhere present in our experience. All yogic practice calls upon us to shift our attention – to step back from the familiar round of thoughts, feelings and sensations that tend to absorb us, and to gently redirect our attention inward. We invite you to join us in doing just that.
Shifting Attention: The Space of Awareness
Bring your attention to the sensations of your body. Let your eyes remain open, taking in the words of the text with a gentle, non-grasping awareness. Move your attention to different parts of the body, noticing the different sensations that arise...
As you attend to various sensations, notice that there is no clear boundary in your awareness between the sensations that make up the body and the space around the body...
As you release the sense of a clear boundary, begin to notice the larger space in which these sensations move...
Allow the sense of this larger space to continue to expand until you lose the sense of it having a beginning or ending, just open space...
As your sense of this space expands, see if you can notice a quality of stillness and calm associated with the unchanging nature of the space, the feeling of simply being which remains unchanged while the sensations continue to move and change in various ways...
Notice any sounds which are occurring, notice that they all occur within this larger space... notice whether near or far, the sounds all exist within the same open space ...
Notice images arising in the mind... these too are moving and changing in various ways, all within this larger space ...
Thoughts arise in space, move through it, dissolve back into it, the space remains, unchanged by whatever moves through it...
Feelings come and go – whether feelings of happiness, sadness, anger, joy, liking or disliking – constantly changing, leaving the space untouched, unchanged...
Staying aware of sensations, images, thoughts and feelings arising and passing away, notice the tendency of the mind to hold on to them, to harden them into solid objects... Releasing this tendency, see if you can become aware of a sense of ease and calm that may emerge as the sense of spaciousness expands... As the feeling of wide open space continues to expand, a feeling of quiet joy may enter into awareness...
Notice how everything moves, changes constantly within this space – sensations, thoughts, feelings – all patterns of moving energy, contained within the space, but not disturbing it...
The Field and the Knower of the Field
Within various spiritual traditions, there are many words to describe these two aspects of experience – the changing, shifting field of sensations, thoughts and images, and the still space of Consciousness in which they exist. The sacred yogic text, The Bhagavad Gita (literally “The Song of God”) refers to these, respectively, as the “Field” and “Knower of the Field.”vi
The Knower (or “Conscious-Being”) refers to that Infinite Being which holds the entire universe within Its Awareness. It is also That which, at this very moment, is seeing through our eyes, but which – in the words of the Kena Upanishad – “our eyes cannot see... which hears through our ears, but our ears cannot hear.”vii It is seeing and hearing equally through all eyes and ears – those of an ant as well as those of a cat or human being. It remains aware whether we are awake or asleep. We can get a sense of it by looking for that in us which is unchanging from infancy through all the changes of life, that core feeling of “I am” in the depths of our psyches.
This Infinite Conscious-Being is frequently referred to as “God,” but that word has so many images and associations attached to it, it rarely serves as a portal to experience. Describing the advantage of a simple word like “Being,” Ekhart Tolle writes:
The word ‘Being’ explains nothing, but nor does ‘God’. Being, however, has the advantage that it is an open concept. It does not reduce the infinite invisible to a finite
entity. It is impossible to form a mental image of it. Nobody can claim exclusive possession of Being. It is your very essence, and it is immediately accessible to you as the feeling of your own presence, the realization “I am” that is prior to “I am this” or “I am that.” So it is only a small step from the word “Being” to the experience of Being.viii
The Field (or “Conscious-Energy”) includes all that we sense – sights, sounds, physical sensations, tastes and smells; all that we feel – pleasure and pain, liking and disliking, anger, joy, love, sadness; and all that we think – our beliefs, memories, plans, worries, ideas, and the images passing through our minds; everything that exists within space and time. All are forms of Conscious-Energy, movements of Conscious-Energy arising out of the Being of the Knower – over billions of years of evolution, throughout our lifetimes, and in this moment and every moment of experience.
All that exists is the interaction of the Knower and the Field. Every atom, every tree, bird, rock and mountain range are movements of Conscious-Energy within the Consciousness of the Being at the center of all things. But these two – the Knower and the Field, Conscious-Being and Conscious-Energy – are not actually two. They are inseparable aspects of one unbroken Infinite Reality – one aspect being the still, changeless, witnessing Consciousness, the other an ever-moving, ever-changing Consciousness – outside of which nothing exists.
i Regarding postmodernists’ concerns about “totalizing” systems: the “view from infinity” is neither a system nor a view.
ii Acts 17:26-28.
iii Exodus, 3:14
iv Heschel, A., God in Search of Man.
v Sri Aurobindo, Savitri, Book I, Canto II, Verse 37.
vi The Bhagavad Gita, Chapter 13, Verse 2. For translation, see Sri Aurobindo, Essays on the Gita.
vii Kena Upanishad, Part I, Verses 6 and 7.
viii Tolle, E., The Power of Now, p. 14.
Saturday, June 24, 2023
Your Phone Is a Mindfulness Trap
Your Phone Is a Mindfulness Trap
Relying on apps for meditation is a recipe for distrac—hold on, I just got a text.
“Let’s travel now to moonlit valleys blanketed with heather,” Harry Styles says to me. The pop star’s voice—just shy of songful, velvet-dry—makes it seem as if we’re at a sleepaway camp for lonely grown-ups, where he is my fetching counselor, and now it’s time for lights out.
Styles’s iambic beckoning lies within a “sleep story” in the mindfulness app Calm. Like many of its competitors, Calm has become a catchall destination for emotional well-being. In recent years, I’ve cycled through several of these platforms. Using them turns the amorphous, slightly unaccountable act of meditation into something I can accomplish, and cross off the list. That’s the forte of the modern mobile app, after all: easing the completion of a discrete task. Send an email, watch a show, order Kleenex, run at a moderate pace for 30 minutes, doomscroll yourself to sleep. There’s an app for it, and you’ll know when you’re done.
The most popular mindfulness apps have roots in this model, outcome-oriented and timebound. Traditional meditation disciplines can be open-ended, fuzzy, and noncommittal in their benefits, which might take months or years to accrue. Plus, they are disciplines, anchored in study and practice and receiving instruction, and, quite often, traversing periods of frustration. Calm, Headspace, Insight Timer, and Ten Percent Happier all offer neat repackagings of the underlying product. Don’t have half an hour to sit around in witness of your inner being’s birthright quietude? No problem: Here’s a three-minute guided option for the bus. Maybe you’re going through a bout of insomnia and heard that a mindfulness practice could help? To put you to bed, here’s a spoken lullaby from Matthew McConaughey.
There is obvious good in this—in anything that dials down the temperature, that provides some relief from the ever-present human thrum of animus and danger. Headspace—the thing, not the brand—is something 100 percent of us could use more of. And these have been popular years for Big Mindful. In 2022, Calm reportedly had 4 million paid subscribers. In 2021, Headspace merged into a health-care endeavor backed by Blackstone that was valued in the billions. Fox is expanding the Ten Percent Happier franchise into a TV show—a comedy. Peace of mind is a business opportunity.
Read: The app that monetized doing nothing
But what are the apps selling, really? Mindfulness—let’s define that tersely as the ability to be present in your sensations without judgment—is an aim compatible with a range of lifestyles and beliefs. It’s so compatible as to invite blanket application: mindful eating, mindful meetings, mindful sleeping, mindful fights. Stripping some of the negative charge from life’s tediums and hardships can benefit anybody. But the mindfulness platforms have taken each of these use cases as a jumping-off point for another tile on the screen, another video or podcast, another claim on your gaze. And here, mindfulness seems to blur into something bigger and so different as to verge on its opposite: mindfulishness.
The first time I quit Headspace was because of an ad—for Headspace—on the subway. I don’t remember exactly what it said, but it was akin in spirit and tone to “I meditate to crush it,” part of the company’s 2016 growth campaign. This frontally transactional framing so reviled me—and so differed from my experience, which is that meditation doesn’t mimic the reliability of a Toyota—that I canceled my subscription on the spot.
By coincidence, I’d recently started to frequent a place where phones weren’t even allowed: a yoga studio. I’m 6 foot 3, with hamstrings that could wire a tennis racket, and restless down to my organelles. But a cycling crash had sent me to physical therapy, which sowed the first seeds of flexibility and balance, along with just enough patience to make it through a simple restorative-yoga class. In the early days, I was treading a sea of thoughts and anxieties, my attention on everything but my breath and the poses. As the practice became less foreign to my body, and helped me release deeply buried tensions, I would leave with an unprecedented sense of stillness. This was more than a five- or 10-minute retreat from the buzz of life, and—even as I got into more vigorous classes—it was more than a workout: It was a complex orchestration, the body marshaling itself in support of the mind’s deliberate, repetitive self-grounding.
If only there were always an hour for yoga. In a frenetic job leading the news desk at The New York Times, during and after the 2016 presidential race, I missed the hand’s-reach lull of Headspace—particularly the bright, lilting vibe and voice of its co-founder and front man, Andy Puddicombe, a former Buddhist monk. There’s something primally calming about a few minutes with a pleasantly timbred human, confident and chill, and Puddicombe is as adept a meditation teacher and guide as I’ve encountered. So I signed up again, and off I’d go mid-morning to a borrowed glass-door office.
Still, I found myself more and more inclined to fidget with my phone, instead of meditate, as Puddicombe spoke. On some days, I would finish my meditation without even a single moment of interior quiet. This is a problem easily enough solved, I know: Just turn up the volume and put the phone across the room. But anyone who has ever had an hour slip away to texts knows that it’s not that simple. Your phone can be anything—including a grenade, its target the cohesion and integrity of your thoughts. For almost anyone who owns one, a smartphone is not only the most omnipresent distraction from a mindfulness practice; it’s also most likely a principal vector for much of the stuff that unfocuses, stresses, addicts, enrages, or dismays you. Just having your phone in the room—it can be in your pocket, turned off—has been found to meaningfully diminish cognitive capacity. Using it to meditate, I started to realize, is like learning you have high cholesterol and signing up for a subscription to bacon.
The most productive move for any mindfulness app would be to engineer ways for you to spend as little time interacting with your phone as possible, as you focus on centering your awareness. But most of the big meditation apps have something less obvious in common than their nominal purpose: They’re subscription-driven content machines whose existence depends on you consuming the content. Open one up and you’re likely to see a whole day of programming laid out for you. In Headspace, for example, you can start with a few deep, animation-assisted breaths, then watch a moody video about an in-the-zone English bookbinder, before you even get to the day’s main meditation, with a choice of two English-language guides or a German one. When the 3 o’clock doldrums hit, slide into “Your Afternoon Lift,” a video of nature scenes: whales frolicking, jellyfish jellying. And nod off later to a sleepcast, or switch apps and return to Harry Styles’s moonlit valleys.
Read: The app that reminds you you’re going to die
I spoke with representatives of Calm and Headspace for this story, and both emphasized to me the ways their apps could be used without actively looking at a screen. They also defended the value of the access that phones provide: meditation anywhere, anytime, for people who might otherwise lack exposure to mindfulness techniques. Under this view, the omnipresence of phones is a blessing. “We would have folks who would download the app in the parking lot of the hospital while their mom is in surgery to have this kind of anchor point of support,” Cal Thompson, who runs design at Headspace, told me. “Some people have great friends they can call, some people have a great teacher on speed dial, but really, not everyone can have that.” As Thompson spoke, I thought of those days back at the Times, when a few minutes with Andy Puddicombe were the only port in a storm.
Thompson didn’t buy my argument about phones being too much of an intrinsic distraction. “I think that’s the dynamic that a lot of us have created with our phones, that we’ve set it up in such a way where it can consume our attention,” Thompson, who uses they/them pronouns, said. “And what we actually need to own and change is that behavior.” Attaching mindfulness practices to more parts of our day, they contended, helps us “get more clear about what we are doing in our lives and make more mindful choices. And then, from that place, it makes it a lot easier for us to use or not use our phones.”
This way of looking at things resonated with me, to a degree, as I listened back to my recording of our conversation. Then it took me three tries to transcribe Thompson’s quote. First my boyfriend texted me about the grocery list. Then someone needed my Venmo name to sell me some tickets. Then I looked up and realized I was in the kitchen for another round of peanut-butter pretzels. I might be generalizing too much based on my own attentional inadequacy, but lots of people I know use their phone more than they want to. If it’s not a universal affliction, it’s common. In my own case, meditating has not solved that problem, but moving meditation away from my phone has made it more of a refuge.
The word mindfulness is an accurate label insofar as it describes paying attention to the content of our mind. But it misleads, as I found in yoga, in its omission of our body. The path to thinking and feeling from hormones and nerves is in some sense linear, often traceable. And the physical state of the organism—pained, eager, bracing, soft—tracks with the text and nature of our thoughts. A professor of mine once referred to bodies as “brain buckets,” an image that anyone who’s gone through the physical deprivations of finals week can relate to. Most phone apps have their business with the brain, not the bucket. But my professor was joking: Everything we are comes from the whole big blob.
A phone is not a villain, just a vessel. But with some narrow exceptions, where movement is the point, it does tend to exert on us a kind of physical binding, an arrest of motion and focus. Some of the apps I’ve mentioned include a daily yoga video or cues for a mindful run, but these serve a double purpose, roping our assertions of embodiment back into the hungry domain of the screen. Do you know what else is on that screen? Instagram. The effect of a mindfulness app, as with any other kind, is to keep you in the place you already spend much of your time. It’s a motionless place, and, not by coincidence, also a bit mindless.