Blinded by Science!

Stories of Trauma

RestorativeChaosQuestStep outside of storey

What are relationships?

What are relationships?Awareness

Your Self (EGO)

Who is in Control?

Awareness Self

Do You Know Where Your Mind Is Right Now?

• UC Santa Barbara mind researcher Jonathan Schooler studied awareness of mind wandering in two projects

• STUDY #1: subjects read War & Peace for 45”, self reporting their awareness of mind wandering

• Subjects reported an average of 5.4 episodes of noticing mind wandering

Schooler Study #2

• STUDY #2 included the same reading material for 45” but introduced random questioning from researchers about whether the subjects were on- or off-topic

• RESULTS: subjects were off-topic on average 43 times in 45”

• Significance: most subjects were unaware of how often their minds wandered

A Wandering Mind Is An Unhappy Mind

• Harvard researchers Killingsworth and Gilbert used a novel iPhone app to randomly contact over 2000 subjects during the day to ask three questions:

– 1: How are you feeling right now?– 2: What are you doing right now?– 3: Are you thinking about something other than

what you are currently doing?

Results:

• 46% of all samples indicated mind wandering• People were less happy when their mind

wandered than when they were focused on a task• Even when their minds wandered to pleasant

topics they were no happier than when focused on a task

• Possible Conclusion: if what we think about effects our happiness, shouldn’t we be more aware of our patterns of thought?

8 Weeks To A Bigger Brain

• Test subjects participated in an 8-week MBSR program at the University of Massachusetts Center For Mindfulness

• Meditators spent about 27” a day listening to pre-recorded guided meditations, and attended a weekly group meditation

• Subjects showed increases in pre-frontal cortex thickness • Sara Lazar, PhD, the study's senior author, stated, "This study

demonstrates that changes in brain structure may underlie some reported improvements and that people are not just feeling better because they are spending time relaxing."

MEDITATION IS TOOL OF MINDFULNESS

Lazar et al. Neuroreport. 2005 November 28; 16(17): 1893–1897.

Age Smarter?

Brain Structure changes

Replicated findings in second Study by Holzel et al., 2007

Increased grey matter HippocampusLeft inferior temporal gyrus

Right anterior insula

Changes in brain structure with 8 week meditation practice

• Holzel et al. 2011• 16 people – 8 week MBSR• Average daily practice 27 minutes• Changes in grey matter thickness– - Hippocampus (learning and memory) temporal/parietal juncture (self-referencing)

posterior cingulate cortex (attention)Amygdala (stress response)

Lazar et al. Neuroreport. 2005 November 28; 16(17): 1893–1897.

Effect MBSR On Grey Matter

Lazar et al. Neuroreport. 2005 November 28; 16(17): 1893–1897.

Memory Modulation

Lazar 2010

Physiological consequences of stress driven by catecholamines and cortisol

é heart rateé blood pressureé blood flow to musclesê blood flow to skin é metabolic rateê digestioné blood clotting and thickness

é blood sugaré respiratory rateé fluid retentioné alertnessé breakdown of fatstriglycerides and LDL

cholesterol

(c) Lipsenthal 2011

Effects Mindful Practices• weight• blood sugar• bp• Improved lipid profile• cortisone• inflammation• Improved well-being, alertness• pain with stress

• brain size, grey matter• quality of life• concentration• learning• sleep quality• body awareness• depression • Changes DNA activation

NIH conference 2009 Mind/Body Med.

MBSR and Cancer Survivors

• Decreased anxiety• Decreased depression• Decreased distress• Decreased

inflammatory cytokines• Decreased cortisol• Decreased adrenaline

• Improved antibody response

• Improved cellular immunity

• Improved well-being• Less physical symptoms• Improved emotional

state• Improved Relationships

Stress Management and Medication Errors

GROUP ERRORS/MONTH

BEFORE INTERVENTION 10.25 ±3.45AFTER INTERVENTION 5.14± 3.45*

*P=.02

Jones & Barge, J Appl Psych, 73(4)1988, 727-735

Mindfulness Associated with Decreased Pain intensity &Catastrophizing.

Shutze et al. PAIN. 148 (2010) 120-127

Ornish et al., 2008

Practicing mindfulness may change gene expression

Dusek et al., Plos one, July 2009 vol. 3 e2576

Effects of Meditation on Cognitive and Academic Performance

• Mindfulness improve ability to process information (Slagter et al. 2007, attentional blink)

• Concentration practice improved academic achievement (Hall, 1999, 56 undergrads, GPA)– Shauna Shapiro, Kirk Brown, John Astin, and

edited by Maia Duerr

Cortical Thickness and Age

• Measured thickness of the cerebral cortex in 20 Insight meditation practitioners with average of 9 years practice of 40min/day

• Mean thickness unchanged, but regions show difference

• Slower thinning w. age

Scatter plot of mean cortical thickness of each participant in the subregion above threshold within each circled region of (c) insula and (d) BA 9/10, plotted versus age. Meditation participants: blue circles; control participants: red squares.

Overview: Mindfulness and Mental Health

General Population Clinical samples• Attention ** INCREASE Feasibility level• Mood **** INCREASE RCT for relapse• Anxiety **** DECREASE Mixed findings• Aggression * DECREASE Case reports• Substance * DECREASE RCT for relapse

Smalley and Winston: Fully Present: The Science, Art and Practice of Mindfulness, 2010

Loving Kindness Meditation

Compared with a closely matched control task, even just a few minutes of loving-kindness meditation increased feelings of social connection and positivity toward novel individuals on both explicit and implicit levels. These results suggest that this easily implemented technique may help to increase positive social emotions and decrease social isolation.

Hutcherson et al, Emotion. 8(5), 2008Fredrickson et al, J Person and Soc Psych, 95(5), 1045, 2008

MBSR has demonstrated its usefulness in treating:

• Chronic Pain• Psoriasis• Anxiety & Panic Disorders• Depression• Fibromyalgia• Prostate & Breast Cancer• HIV/AIDS & other illnesses

Clinical research demonstrates long-lasting improvements:

• Improved health-related quality of life• Reduced chronic pain & physical

distress• Fewer and less intense headaches• Reduced pain-related drug use• Decreased blood pressure• Strengthened immunity• Improved sleep quality• Reduced tension, anger and fatigue

Acta Anaesthesiol Scand 1999; 43: 583–602

END

Meditation Brain Studies

Gamma activity

PNAS 101(46) 2004, 16369

EEG Gamma Activity During LT Meditation

PNAS 101(46) 2004, 16369

Gamma waves represent coherent, concentrated cognitive acts and insights.

Change EEG with - emotion

EEG Effect on 4 months Of Meditation

Alpha asymmetry is associated with more adaptive responding to negative events.

P<.01

Trait Anxiety Before and After MBSR

Paying attention

• Random iPhone questions• 5000people, 83 countries, age 18-88• “How are you feeling?”, “What are you

doing?”, “Are you thinking about something besides what you are doing?”

• Happiness: When paying attention, people are happier.

Killingsworth and Gilbert, Science. 2010 Nov 12;330(6006):932

Experiential vs. the Narrative Self

• Experiential – right hemisphere structures predominate

• Narrative self – midline structures and left hemisphere language structures (what our brain’s tend to favor) aka…….wandering mind state, SIT, default brain state

• Harvard study says we spend about 47% of our time in this wandering mind state (not fully present) and that it is negatively correlated with happiness (iphone research; Science, 2010)

Telomerase study• 30 meditators/30 controls• 3 month meditation retreat (6 hours / day)• Telomerase activity in meditators significantly

higher after retreat (not tested prior)• Jacobs et al. 2010

Reported decrease in ADHD symptomsADHD self-report scales (or parent report)

Pre Post0

2

4

6

8

10

12

14

16

18

Inattentive, p<.01

Hyperactive, p<.01

Zylowska et al., J Attention Disorders (2007)

Mindfulness and stress reduction(many studies of MBSR program)

Over 50+ studies show reduction in stress and anxiety across a wide range of clinical (pain,

cancer, HIV) and non-clinical (children, adolescents, adults, elderly) samples

Many studies show a reduction in biomarkers of stress – like cortisol

Smalley and Winston: Fully Present: The Science, Art and Practice of Mindfulness, 2010

Mindfulness and Social Anxiety

• 2 studies by Stanford group (Goldin)• Narrative ‘self’ vs. ‘Experiential’ self• Social anxiety – elevated self-referencing,

negative thoughts of self and that others are judging them

• Mindfulness reduced negative thoughts• Brain changes – less activation in ‘narrative’

self structures

Mindfulness….Increases attention

Reduces stress / anxiety

Increases mood – sense of well-being

Increases meta-cognitive stanceReduces narrative and increases experiential self focus

Reduces aggression/hostility A Useful Tool for enhancing well-being

What does practicing it do?

increases self-regulation

of body, emotion and cognition

some likely lasting effects (more trait-like)

General population -

• increased self-reports of happiness, decreased mood, improved wellbeing

• Decreased stress and anxiety

Clinical groups:

• Depression - reduced relapse - MBCT (RCT) relapse rate 37% vs. 66-78% in TAU; Teasedale et al., 2002; Ma and Teasdale 2004

Anxiety disorders -some positive, some negative; not ‘quite’ as good as CBT (Kosycki et al., 2007)

Impact of mindfulness practice on ADHD symptoms - pilot study

Zylowska et al., J Attention Disorders (2007)

Those practicing mindfulness commonly report experiencing:

• Relaxed awareness of the present moment• Enhanced psychological flexibility• Release of attachment and aversion • Greater stress tolerance & impulse control• Clarity and awareness of thought patterns• Greater insight

Ornish et al., PNAS 2008

Practicing Mindfulness Can Change Gene Expression

48 up-regulated and 453 down-regulated transcripts

How Mindfulness Works

• Selfing, isolation, rumination, burnout • Quieting the mind, attention and concentration• Disidentification with thoughts and emotions• Broadening of attention• Increased connections to others and world• Positive emotions and self compassion• Improved outlook

Modified from Garland 2010

Enhanced cognitive performance• Mindfulness training enhances the ability to

focus attention and preparedness– Jha, A., Krompinger, J., & Baime, M. J. (2007).

Mindfulness training modifies subsystems of attention. Cognitive, Affective, & Behavioral Neuroscience, 7, 109– 119.

Stress Reduction and Malpractice

Jones & Barge, J Appl Psych, 73(4)1988, 727-735

IMPROVEMENTS WITH 8 WEEKS MBSR TRAINING

• Mindfulness• Burnout (all scales)• Empathy• Physician Belief Scale• Mood disturbance• Personality stability

P<.001

Krasner et al JAMA302(12): 1293, 2010

Change EEG with - emotion

EEG Effect on 4 months Of Meditation

Alpha asymmetry is associated with more adaptive responding to negative events.

MBSR Improves Sleep in Cancer Patients

International Journal of Behavioral Medicine2005, Vol. 12, No. 4, 278–285

Daytime***anxietydepressionangerfatigueconfusionvigor

MBSR and Breast Cancer

Lengacher CA et al 2009

N=84 Hours MBSRPhysical functioningPerceived stressPainEmotional well-being

Effect MSRB on Cancer Patients

L.E. Carlson et al. / Brain, Behavior, and Immunity 21 (2007) 1038–1049

MBSR/QOL and Breast Cancer

Total QOL

Psych QOL

Family QOL

L. Witek-Janusek et al. / Brain, Behavior, and Immunity 22 (2008) 969–981 975

Enhanced GPA with meditation• Randomized controlled trial with college students• 56 undergraduates to two study groups– concentration-based meditation.

• 20 minutes of meditation twice weekly, attention focus and relation• The control group also met for one hour of study a week but was

not introduced to meditation.

• The groups did not differ in grade point average (GPA) at the beginning of the study

• In the next semester, the treatment group had significantly higher GPA scores compared to the control group. – Hall, P. D. (1999). The effect of meditation on the academic performance of African American college students. Journal of

Black Studies, 29 (3), 408–415.

115 cancer pts Rx MBCT for 8 weeks* v Wait

• Improved anxiety• Improved depression• Improved distress• Improved mindfulness• Improved quality of life

•1 hour homework/day• J. Consulting and Clinical Psych. 78(1), 2010, 72-79

Effect MSRB on Cancer Patients

L.E. Carlson et al. / Brain, Behavior, and Immunity 21 (2007) 1038–1049

MBSR & blood cytokines

L. Witek-Janusek et al. / Brain, Behavior, and Immunity 22 (2008) 969–981

Cytokines make you feel like you have the flue.