Many people like Open Focus because it is based on scientific research. I remember, it was also important for me when I first came across Dr Fehmi’s book. There was no story attached to four attention styles theory. It did not want me to believe in something. It described my experience and connected it to the brain physiology. That was it — clean and elegant.

I know from Dr Fehmi that he purposely keeps Open Focus away from any religious or spiritual connotations. He tries to make it as scientific as possible. I must say, it is a lot harder for me because the four attention styles theory and attention flexibility is such a good tool to understand and categorise various types of mediation techniques and spiritual teachings. You can have a quick look at these two papers (link, link) and I am sure you will agree with me. It also helps me to recognize which spiritual teacher truly explains the essence of reality and who does not. As far as I am concerned there is a deep wisdom in Dr Fehmi’s theory and suggested practice which once absorbed makes life less complicated and a lot easier to live.

Ok, back to the science. The fact is that there is no formal scientific research validating the dissolving pain in Open Focus technique. I have been trying to fill this gap for some time and to engage UK academics in researching this. One can notice a renaissance of interest in the brain alpha oscillations over the last few years. I was hoping to take advantage of it. This is an extract from an email I sent to them.

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The dissolving pain in Open Focus exercises are the mind exercises which sound like guided meditation and last 15 to 30 minutes. The pain alleviating mechanism is based on switching attention style from narrowly focused on the pain to more broad (attending the pain and a wide array of stimuli at the same time). This style of attending quiets down an internal chatter, helps to accept pain and immerse in it. Once this is done for sufficient amount of time, the pain merges with its background and subsides or completely dissolves.

The key in this method is 
– simultaneous awareness of wide array of stimuli including the pain – the diffused attention style (similar to mindful open monitoring)
– immersing with the pain – the immersed attention style (true acceptance, letting go in other methods, see: Acceptance and Commitment Therapy) 
– awareness of space inside and around the pain – it triggers both – diffused and immersed attention styles (not present in other methods)

These three attentional directions stimulate alpha waves power and inhibit processing of pain in relevant areas of the brain, according to Dr Lester Fehmi, the author of the four attention styles theory.

Dr Fehmi is a neuroscientist and psychologist  who runs his clinic for attention disorders in Princeton, New Jersey, US. He has been developing methods of increasing alpha power in the whole brain using a neurofeedback EEG machine of his own design for almost forty years. According to Dr Fehmi attending the pain using more diffused and immersed attention styles activates functional inhibition of neuronal regions responsible for pain experience. It is achieved by stimulating alpha oscillations in relevant areas.

As you may be aware alpha oscillation has been suggested as top-down cortical inhibition by many researchers (1, 2, 3, 4). It also has been shown that strong pre stimulus alpha power in task-relevant regions negatively affects subsequent stimulus processing (5, 6, 7, 8, 9). Also degree of alpha lateralisation have been linked to ability to ignore task irrelevant hemifield and sustain attention (16, 17, 18, 19).

You can, watch a short presentation explaining the neurophysiology mechanism of the exercise.

The exercises are safe, easy to learn and effective. Many of my patients have already participated in them with good results. Pain is usually significantly reduced after the first time, and in some patients pain dissolves completely. Most of the patients achieve significant pain reduction after 4-5 days of regular exercising. 

The other advantages are
⁃ a very fast induction (broadening an attention and then immersing in a pain), 
⁃ simplicity (simple, direct instructions, no usage of complicated imagery which might be difficult for some), 
⁃ no need for time consuming introduction to the method (important in a family doctor setting),
⁃ the exercises are based on scientific approach so there is no need for re-adjusting personal belief systems,
– they can be adjusted to a particular patient needs and abilities.

It is worth mentioning that the same principle (augmenting perception by increasing alpha power in the brain structures processing a stimulus by changing an attention style) can be used to inhibit perception of many internal or external stimuli like itch, hunger, anxiety, fear, cold, etc.

I have been experimenting with this approach for last five years with many interesting results. Changing attention style helps in many everyday situations like walking into a swimming pool with cold water, after sitting for prolonged time with legs crossed and slowly getting up experiencing pins and needles in my legs.


I (and some of my friends and patients) have already experimented with unpleasant smells, itch, anxiety, fear, hunger, etc. In all these situations there is significant shift or perception. It sometimes requires training but it is achievable by many.


By regular practice, I have significantly improved my attention span, I have learned how to control my physical pain and to reduce stress. I can fall asleep every time when I want, I communicate better with my patients and I can be creative on demand. I believe, I have positively influenced my personality becoming better father and better doctor for my patients.

I believe this approach is worth researching and promoting as it can quickly become a very practical tool for pain sufferers, people struggle with anxiety or memory problems, etc. For example, a short version of the pain dissolving exercise could be added to the existing list of pain remedies which can be recommended by health professionals to their patients. 

Please, see a choice of relevant papers.

Alpha oscillation has been suggested as top-down cortical inhibition.
1. Shaping functional architecture by oscillatory alpha activity: gating by inhibition.
. Jensen O, Mazaheri A
. Front Hum Neurosci. 2010; 4():186.
. [PubMed]
2. The Role of Alpha-Band Brain Oscillations as a Sensory Suppression Mechanism during Selective Attention.
. Foxe JJ, Snyder AC
. Front Psychol. 2011; 2():154.
. [PubMed]
3. An oscillatory mechanism for prioritizing salient unattended stimuli.
. Jensen O, Bonnefond M, VanRullen R
. Trends Cogn Sci. 2012 Apr; 16(4):200-6.
. [PubMed]
4. Pulsed out of awareness: EEG alpha oscillations represent a pulsed-inhibition of ongoing cortical processing.
. Mathewson KE, Lleras A, Beck DM, Fabiani M, Ro T, Gratton G
. Front Psychol. 2011; 2():99.
. [PubMed]

It has been shown that strong pre stimulus alpha power in task-relevant regions negatively affects subsequent stimulus processing.
5. Alpha rhythm of the EEG modulates visual detection performance in humans.
. Ergenoglu T, Demiralp T, Bayraktaroglu Z, Ergen M, Beydagi H, Uresin Y
. Brain Res Cogn Brain Res. 2004 Aug; 20(3):376-83.
. [PubMed]
6. Visual discrimination performance is related to decreased alpha amplitude but increased phase locking.
. Hanslmayr S, Klimesch W, Sauseng P, Gruber W, Doppelmayr M, Freunberger R, Pecherstorfer T.
. Neurosci Lett. 2005 Feb 25; 375(1):64-8.
. [PubMed]
7. Prestimulus oscillations predict visual perception performance between and within subjects.
. Hanslmayr S, Aslan A, Staudigl T, Klimesch W, Herrmann CS, Bäuml KH
. Neuroimage. 2007 Oct 1; 37(4):1465-73.
. [PubMed]
8. Prestimulus oscillatory activity in the alpha band predicts visual discrimination ability.
. van Dijk H, Schoffelen JM, Oostenveld R, Jensen O
. J Neurosci. 2008 Feb 20; 28(8):1816-23.
. [PubMed]
9. Prestimulus alpha and mu activity predicts failure to inhibit motor responses.
. Mazaheri A, Nieuwenhuis IL, van Dijk H, Jensen O
. Hum Brain Mapp. 2009 Jun; 30(6):1791-800.
. [PubMed]

Alpha power lateralisation suggest an inhibition of the task irrelevant hemified and has been shown to lead to better task performance.
10. Anticipatory biasing of visuospatial attention indexed by retinotopically specific alpha-band electroencephalography increases over occipital cortex.
. Worden MS, Foxe JJ, Wang N, Simpson GV
. J Neurosci. 2000 Mar 15; 20(6):RC63.
. [PubMed]
11. Alpha-band electroencephalographic activity over occipital cortex indexes visuospatial attention bias and predicts visual target detection.
. Thut G, Nietzel A, Brandt SA, Pascual-Leone A
. J Neurosci. 2006 Sep 13; 26(37):9494-502.
. [PubMed]
12.The strength of anticipatory spatial biasing predicts target discrimination at attended locations: a high-density EEG study.
. Kelly SP, Gomez-Ramirez M, Foxe JJ
. Eur J Neurosci. 2009 Dec; 30(11):2224-34.
. [PubMed]
13. Neurophysiological signals of working memory in normal ageing.
. McEvoy LK, Pellouchoud E, Smith ME, Gevins A
. Brain Res Cogn Brain Res. 2001 Jun; 11(3):363-76.
. [PubMed]

Strong alpha during the immediate rehearsal of an item has been shown to predict the long term memory encoding success.
14. Increase in posterior alpha activity during rehearsal predicts successful long-term memory formation of word sequences.
. Meeuwissen EB, Takashima A, Fernández G, Jensen O
. Hum Brain Mapp. 2011 Dec; 32(12):2045-53.
. [PubMed]
15. Blocking of irrelevant memories by posterior alpha activity boosts memory encoding.
. Park H, Lee DS, Kang E, Kang H, Hahm J, Kim JS, Chung CK, Jensen O
. Hum Brain Mapp. 2014 Aug; 35(8):3972-87.
. [PubMed]

Degree of alpha lateralisation have been linked to ability to ignore task irrelevant hemifield and sustain attention.
16. Attention-dependent suppression of distracter visual input can be cross-modally cued as indexed by anticipatory parieto-occipital alpha-band oscillations.
. Fu KM, Foxe JJ, Murray MM, Higgins BA, Javitt DC, Schroeder CE
. Brain Res Cogn Brain Res. 2001 Aug; 12(1):145-52.
. [PubMed]
17. Top-down controlled alpha band activity in somatosensory areas determines behavioral performance in a discrimination task.
. Haegens S, Händel BF, Jensen O
. J Neurosci. 2011 Apr 6; 31(14):5197-204.
. [PubMed]
18. Alpha activity reflects individual abilities to adapt to the environment.
. Horschig JM, Jensen O, van Schouwenburg MR, Cools R, Bonnefond M
. Neuroimage. 2014 Apr 1; 89():235-43.
. [PubMed]
19. Alpha entrainment is responsible for the attentional blink phenomenon.
. Zauner A, Fellinger R, Gross J, Hanslmayr S, Shapiro K, Gruber W, Müller S, Klimesch W
. Neuroimage. 2012 Nov 1; 63(2):674-86.
. [PubMed]

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I have sent this research offer to many UK academics. Some of them were initially interested (or very interested) but then they stopped contacting me for various reasons. I was initially against running any research on my own because I thought it would not look very reliable. However, I am considering doing it now. Please, let me know through the contact form if you would like to participate in this research.

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You can watch another presentation explaining mechanism of the exercise in less scientific language.

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