A first Attention Training Technique session takes about twelve minutes[1] and is designed to be demanding. The protocol does not promise an immediate subjective payoff, so how you feel after one session is not a test of whether the exercise has a longer-term effect.

What happens, in order

  1. Sounds are introduced. Several at once, at different distances — the manual’s layout is at least three competing sounds in the room, two more nearby, and two in the far distance[1]. Some locations may be silent; the manual calls those potential sounds[1].
  2. Your gaze settles. Eyes stay open on a fixation point — the manual’s example is a dot — held throughout[1].
  3. Selective attention, about five minutes. The voice names one sound; you give it your full attention. When your attention strays or is captured, you refocus on the named one[1].
  4. Switching, about five minutes. The same, faster — roughly every ten seconds at first, then every five[1].
  5. Divided attention, about two minutes. Attention widens to take in all the sounds at once, with a covert count of how many you can hear[1].

What a beginner should expect to feel

Effort, and more of it in the middle. The switching phase is the demanding one — in a study that rated effort per phase, switching drew the highest ratings of the three[2]. If the middle of the session feels like the hard part, that is the shape of the exercise, not a beginner’s weakness.

Losing the sounds, repeatedly. The script is written on the assumption that attention will be captured, with a refocus instruction attached to every direction[1].

Thoughts, arriving throughout. They are meant to be treated as additional noise and not resisted — you must not try to stop them, and they are to be thought of as passing inner noises[1]. Wells notes the misconception directly: some people assume they practised ineffectively because they had intrusive thoughts[1].

No particular calm afterwards. ATT should not be used as a distraction, avoidance or symptom-management strategy, and is not intended as an emotion-management strategy[1]. A session that leaves you feeling much the same is behaving as specified.

What not to conclude from session one

  • “I was terrible at it.” The manual’s measure is whether you keep bringing attention back, not whether you held it[1].
  • “It didn’t do anything.” ATT is described as training, framed to patients as general mental fitness training[1] — a category where a single repetition is not expected to announce itself.
  • “It’ll get easier.” Deliberately not. The exercise is meant to stay attentionally demanding, with the sounds and their arrangement varied between sessions to offset the effects of practice on difficulty[1].

Setting yourself up

The protocol has ATT practised when the person is not in a state of anxiety or acute worry[1]. So the time to do a first session is a fairly ordinary moment — not a bad evening you are hoping it will fix. You need somewhere you can sit for a quarter of an hour and hold your gaze on one spot, and something to listen with.

On how often to repeat it once you have started, see how often to practise ATT. On the ways a session can quietly go wrong, see are you doing ATT right?.

Questions and answers

What happens in your first ATT session?
Sounds are introduced at different distances, you settle your gaze on a fixed point, and a voice then directs your attention for about twelve minutes: roughly five holding one sound at a time, five switching between them, and two taking them all in at once.
Is the first session supposed to be hard?
Yes. The exercise is designed to be attentionally demanding and to stay that way with practice — Wells' stated rationale is that otherwise it would not strengthen control processes.
What if I lose the sounds constantly?
That is the expected pattern. The script assumes attention will be captured and instructs you to refocus each time; the returning is what is being practised.

References

  1. Wells, A. (2009). Metacognitive Therapy for Anxiety and Depression. Guilford Press. Chapter 4: Attention Training Techniques.
  2. Rosenbaum, D., Maier, M. J., Hudak, J., Metzger, F. G., Wells, A., Fallgatter, A. J., & Ehlis, A.-C. (2018). Neurophysiological correlates of the attention training technique: A component study. NeuroImage: Clinical, 19, 1018–1024. https://pmc.ncbi.nlm.nih.gov/articles/PMC6039840/

Published by the makers of Heed, an app for practicing ATT-style sessions. iPhone · Android. Heed is a self-practice tool inspired by ATT research — not therapy, and not a medical device.