The Neurobiology of Mindfulness: Clinical Applications Ronald D. Siegel, Psy.D.
What is Mindfulness? • Sati in Pali Connotes awareness, attention, & remembering
• In therapeutic arena, also includes Non-judgment Acceptance • Adds kindness & friendliness
Therapeutic Mindfulness
Life Is Difficult, for Everybody
1. Awareness 2. Of present experience 3. With acceptance
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The Problem With Selfing
Breath Awareness
How it Works
Fly
Overwhelmed?
Intensity of experience
Capacity to bear experience
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The Thinking Disease Neurobiology Challenging to Study
• Analyze past pleasure and pain • Maximize future pleasure and avoid future pain
State vs. Trait Effects
Easier Said than Done • State Challenges: What is the meditator actually doing? • Concentrating on the breath • Enjoying a pleasant fantasy • Remembering to run an errand
Structure
Activity
Behavior
Easier Said than Done II • Trait Challenges What are the enduring effects of meditation over time?
Brain Function
• Only certain people choose to meditate • Difficult to get random sample • Tough to do longitudinal studies
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Attention
Cognitive Skills Remain More Intact • Older meditators outperform agematched controls in:
• Improved sustained attention detection of unexpected stimuli
• Reduced attentional blink habituation
Fluid Intelligence
Attentional blink task Short-term memory Perceptual speed Executive functioning Sustained attention
EEG Studies
• Think logically • Sensitive to moment-to-moment changes
• Solve problems in novel situations • Independent of acquired knowledge
• “Blurry” image
Lateral Differences • Left prefrontal cortex activity Happy Enthusiastic Energized
• Right prefrontal cortex activity Hypervigilance Depression Anxiety
Biotech Workers • Taught MBSR 3hr/wk x 8 weeks Subjects tipped right before training Tipped left after training Moods improved • More engaged • Less anxious
Immune response to flu vaccine enhanced
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Left – Right Differences
Neuroimaging Studies • FMRI & PET Jerky video Resolution OK
• MRI Snapshots Resolution Excellent Time 1: Before MBSR Course Time 3: 8 weeks after MBSR Course
Anterior Cingulate Cortex (ACC) • Involved in integration of attention, motivation, and motor control Novice meditators show more activity than Buddhist monks Regular meditators show more activity than non-meditators.
Amygdala • Helps evaluate threats Lion? Beige rock?
Insula • Associated with interoception Visceral and “gut” feelings Processes transient body sensations
• Activated during meditation practice
Prefrontal Cortex (PFC) • Evaluates emotional responses and regulates emotion “Yes, looks like a lion, but lions aren’t found here, so it’s probably a beige rock”
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8 Week Mindfulness Training vs. Stress Reduction for Anxiety Patients • Mindfulness Group (pre-post):
Brain Structure
Amygdala activation decreased more Reported more decrease in anxiety More activation of the Prefrontal Cortex (PFC) More connections between the PFC & amygdala
Structural Changes • Studied long-term Western meditators • Compared to controls, had thicker Anterior insula Sensory cortex Prefrontal cortex
• Differences in thickness most pronounced in older subjects
Cortical Areas Thicker in Meditators
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1. Insula 2. Brodman’s area 9/10
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3. Somatosensory Cortex
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4. Auditory Cortex
Older Meditators Had Greater Gains
Age vs. Thickness (c) Insula (d) Brodman’s Area 9/10 Meditators Blue -- Controls Red
Shrinking Amygdala
Grey matter change in right amygdala vs. change in perceived stress
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Neurobiology of Selfing
Who Am I? • Two types of self-reference Narrative focus • Enduring traits • Talking to ourselves about ourselves
Experiential focus • Momentary experience • The mind-body in action
Default Mode Network (DMN)
Mindfulness and the DMN • Experienced and novice meditators did 3 practices: Focused Attention (Concentration) Open Monitoring (Mindfulness per se) Acceptance (Loving-kindness)
• Main nodes of DMN deactivated
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Posterior Cingulate Cortex (PCC) Neurofeedback • Programed computer to focus on PCC Red upward spikes when active Blue downward spikes when quiet
Meditate by watching graph (graph of PCC, active feedback)
…and then I sort of immediately settled in and I was really getting into it…
Meditate by watching graph (graph of PCC, active feedback)
… and I was like “okay, wait don’t get distracted” and then I got back into it and then it got blue again…
Meditate by watching graph (graph of PCC, active feedback)
So at the beginning, I caught myself, that I was sort of trying to guess when the words were going to end and when the meditation was going to begin. So I was kind of trying to be like “okay ready, set, go!” and then there was an additional word that popped up and I was like “oh shit” and so that’s the red spike you see there…
Meditate by watching graph (graph of PCC, active feedback)
…and then I thought “oh my gosh this is amazing it’s describing exactly what I am saying” and then you see that red spike...
Meditate by watching graph (graph of PCC, active feedback)
…and I was like “oh my gosh this is unbelievable, it’s doing exactly what my mind is doing” and so [chuckles] then it got red again…
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Meditate by watching graph (graph of PCC, active feedback)
To Receive Free Materials …So I just find it really funny because it’s…that’s…to the next question, that’s a perfect map of what my mind was going through.
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NEUROPSYCH
Medial Prefrontal Cortex (mPFC) Mindfulness Reduces Selfing
The Study • Half of subjects engaged in 8 week MBSR course, half on wait list • All trained in narrative focus (NF) and experiential focus (EF) modes of responding to adjectives • All asked to do each approach while in fMRI scanner
• Links subjective experiences across time • Holds memory of Self traits Traits of similar others Reflected selfknowledge Future aspirations
The Results • In novices, experiential focus (EF) reduced self-referential activity in medial prefrontal cortex (mPFC) • In MBSR participants, EF resulted in more marked and pervasive reduced activity in mPFC, along with increased engagement in several other areas
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The Conclusion • There is a fundamental neural dissociation between two forms of self-awareness: The self across time The unfolding of experience in the present moment
• Mindfulness practice enables us to see these as separate To see how the “self” is created out of a narrative
A human being is part of the whole called by us universe ... We experience ourselves, our thoughts and feelings as something separate from the rest. A kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from the prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty. The true value of a human being is determined by the measure and the sense in which they have obtained liberation from the self.
Motivational Systems Anger, anxiety, disgust
Drive, excitement, vitality
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Threat-focused Protection & Safety Seeking
Cultivating Compassion
Seeking pleasure Achieving and Activating
Activating/Inhibiting
Affiliative Soothing/safety Well-being
Contentment, safety, connection
Safety, Satisfaction, Connection Mindfulness, Neurobiology and Pain
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The Story of the Two Arrows
(Pain) x (Resistance) = Suffering
When touched with a feeling of pain, the uninstructed run-of-the-mill person sorrows, grieves, & laments, beats his breast, becomes distraught. So he feels two pains, physical & mental. Just as if they were to shoot a man with an arrow and, right afterward, were to shoot him with another one, so that he would feel the pains of two arrows (Salllatha Sutta [The Arrow] ).
• Pain can be observed to be separate from “suffering”
Pain is Inevitable, Suffering is Optional • Suffering Includes:
Grimacing, wincing, bracing. Aversive thoughts. Wishes for relief. Self-punitive thoughts. Anger, fear, depression regarding condition.
Neurobiology of Pain • Meditators practicing open monitoring (mindfulness per se) when exposed to pain: had decreased activity in the lateral prefrontal cortex (lPFC) – evaluates sensation had increased activation in the posterior insula – registers sensation
• Impermanence as gift as well as curse • Apparently solid pain states are observed to be like frames in a movie, everchanging
Experimentally Induced Pain • Compared to novices, Experienced Meditators: find pain less unpleasant can observe pain less reactively find that open monitoring reduces pain unpleasantness have less anticipatory pain anxiety
Suffering ≠ Pain • 105 randomly chosen pain patients • Independent of pain level, mindfulness reduced Depression Pain-related anxiety Disability • Physical • Social • “Other”
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For tailored meditation practices, visit: www.mindfulness-solution.com email:
[email protected]
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