Neuroscience and Clinical Practice

Dr. Robert J. MacFadden


Content taken directly from: Holzel, B., Lazar, S., Gard, T., Schuman-Olivier, Z., Vago, D., Ott, U.(2011). How does Mindfulness Meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science 6 (6), 537-559.

1.Attention Regulation

Critical first skill
Repeated practice
Strengthened ability
ACC detects conflicts (distractions) & alerts other systems to regulate
ACC with frontal insular cortex, involved in activation of different brain networks, strengthening cognitive control
ACC activated in attention exercises, may reduce activation once control strengthen
Cortical thickness of ACC greater in experienced mediators
Promising but no research yet for ADHD; some early research for bipolar disorders in strengthening cognitive functioning

2.Body Awareness

Ability to notice subtle bodily sensations
Focus is usually on internal body sensations including sensations related to emotions or physical sensations
Reports of better bodily awareness & of internal sensations
Includes greater emotional awareness & ability to differentiate sensations
Insula key player in this and some research to indicate increased insula and somatosensory activity in meditators
Some research showing greater cortical thickness in right anterior insula
By becoming more aware of bodily sensations, this can lead to better awareness of feelings, since bodily sensations are essential in having a sense of a feeling. So increased awareness of emotions and subsequent feelings are crucial to emotional regulation. Bodily awareness is connected to recovery process in borderline personality disorder, eating disorders and substance abuse disorders as examples.

Regarding empathy, accurate internal awareness of one’s own sensations import precondition for empathic response. The insula and temporo-pariental junction is impacted in awareness of one’s own body sensations, in social cognition and empathic responses.

3.Emotion Regulation

Mindfulness can result in improvement in emotion regulation.
Can reduce emotional reactivity
Decrease in negative mood states
Improved positive mood states
Reduced distractive and ruminative thoughts and behaviours
Can increase left prefrontal activation leading to more positive emotions
Prefrontal control systems module emotions and the amygdala and dorsal regions of lateral PFC, ventral PFC
The ACC (monitors control processes)
Typical pattern: increased PFC, decreased amygdala
PFC projections to amygdala exert inhibitory top down control
Mindfulness activates regions relevant to emotional regulation
Improved emotion regulation underlying Mindfulness likely accounts for stress reduction & reducing depression symptoms.

Cognitive Reappraisal
Reinterpreting one’s meaning of a stimulus
Mindfulness involves positive reappraisal
Mindfulness reconstrues stimuli as beneficial, meaningful or benign
Reappraisal involves dorsolateral PFC, orbito PFC and ACC
Some dispute, findings suggesting Mindfulness involves nonappraisal

Exposure, extinction, reconsolidation
Mindfulness encourages exposure to the experience, welcoming it, refraining from engaging in internal activity towards it, bring acceptance to bodily and affective responses
Turn towards negative emotions, which pass away leaving a sense of safety or well-being
Mindfulness avoids enacting safety strategies (e.g, avoiding contact, blocking thoughts, feelings), and focuses attention on responses
High level of relaxation (parasympathetic tone) and decreased sympathetic tone paired with negative stimuli may decrease negativity
Extinction does not erase original association but is thought to form new memory trace or reconsolidate old memory with new (relaxed) contextual associations.
Extinction involves vmPFC and this is strengthened through Mindfulness practice.

Brain network crucial for extinction of condition fear responses and its retention. This network seems to strengthen through Mindfulness. VmPFC involved. Cortical thickness of vmPFC positive correlated with extinction recall.

Hippocampus and VmPFC work together during extinction recall to inhibit fear.

When people regulate their emotions, the hippocampus and the vmPFC involved. This suppresses fear allowing control over behavioural reactions to emotions. Neuroimaging studies have shown that the hippocampus and VmPFC are dysfunctional in PTSD and depression.

Mediators show greater gray matter in the hippocampus for mediators vs non-mediators. Detectable within 8 weeks for new mediators using MBSR.

Reduced scores on perceived stress correlated with a decrease in gray matter in the right amygdala.

Findings suggest thatMM could directly influence one’s capacity to extinguished conditioned fear by enhancing the structural and functional integrity of the brain network involve in safety signaling.

4. Change in perspective on the self
Buddhist teaching says there is no such thing as a permanent, unchanging self. Self is a product of ongoing mental processes. Paying close attention to the changing nature of self, leads to the deconstruction of the self. Changing perception of the self, leads to enduring happiness. It uproots clinging, attachment and hositility.

More positive self-concept, more self-esteem and higher acceptance of self. Brain structures that support self-referntial processing appear impacted by Mindfulness. Medial PFC, posterior cingulate cortex and the inferior parietal lobule are involved.

5. Self-Compassion
Involves self kindness (being kind and understanding towards oneself in situations of perceived inadequacy or suffering rather than being harshly self critical); common humanity (perceiving one’s experience as part of the larger human experience; and mindfulness, defined as holding one’s painful thoughts and feelings in balance awareness, rather than over-identifying with them.

Mindfulness & self-compassion are highly correlated. Cultivation of self-compassion viewed as explaining much of the success of Mindfulness-based interventions.

Self-compassion scores increase with Mindfulness experience. Feeling compassion for oneself is an act of emotional regulation.