Clinical Handbook of Mindfulness (17 page)

are meditations that develop concentration, there are those that develop

Chapter 2 Mindfulness and Meditation

43

mindfulness, and there are those that develop other specific qualities such

as kindness, compassion, appreciative joy, and equanimity. The idea, as it

is stated in an early text, is that “Whatever a person frequently thinks and

ponders upon, that will become the inclination of his mind” (
Majjhima
19)

(Nanamoli & Bodhi, 1995).
In a model where each mind moment arises and passes away in serial progression, with each moment taking a single object

and each object being regarded with either a wholesome or an unwhole-

some attitude, the quality of each mind moment becomes a matter of great

concern. In a moment of anger, for example, kindness cannot simultaneously

manifest. In a moment of confusions, there can be no mindfulness. Psycho-

logical cultivation thus involves abandoning the unwholesome states as they

naturally arise in the mind and encouraging or developing the wholesome

states that arise. Mindfulness is the mental factor of most benefit to those

seeking mental well-being, so the development of mindfulness is a universally

healthy thing to do. Much of Buddhist meditation consists of the cultivation

of mindfulness, and this can only be done with great patience and persever-

ance. Putting aside an hour or two each day or attending a full-immersion

retreat setting from time to time is among the ways to practice being mind-

ful. The
content
of experience in this pursuit is almost irrelevant—one can

be mindful of breathing, of walking, of eating, or of almost any ordinary activ-

ity. What is of most importance is the
quality of attention
brought to these

pursuits.

Summary

What we have outlined above can be seen as a continuum that appears at

this point to have returned to its beginning. We start with the workings

of the ordinary mind, which takes anything that happens to appear in the

mind or senses as an object of awareness, but in an undisciplined and appar-

ently random way. According to Buddhist thought, nothing is truly random

in the human mind and body, however, so what appears to be the sponta-

neously attentive mind is actually a mind reacting to phenomena with host

of unconscious habits, reflexes, and attitudes. To the extent these subliminal

conditioning factors are rooted in greed, hatred, and delusion, our behavior

will continually incline toward more suffering for ourselves and others. To

counter this tendency, we might embark upon the enterprise of deliberately

controlling and disciplining the mind to return to a primary object of aware-

ness during sessions of sustained concentration practice. To some extent this

involves countering the mind’s natural inclination to turn away to something

else, and like any form of discipline, it can seem onerous at first. But as the

mind concentrates it accesses considerable power, and one can chooses to

direct that power either to explore the deeper reaches of altered states of

consciousness or to investigate more carefully the flow of ordinary experi-

ence. When, in mindfulness meditation, awareness is encouraged to roam

freely over the phenomena of experience, it does so with qualitatively more

clarity and continuity than is accessible in ordinary states of mind.

The benefits of this heightened capability of awareness are manifold, both

within and outside the Buddhist context. Traditionally, mindfulness was seen

as a tool to be used for gaining wisdom, which consists of the direct,

44

Andrew Olendzki

experiential understanding of the impermanence, selflessness, unsatisfactori-

ness, and interdependence of all phenomena. This might not seem like much

at first glance, but the implications of these insights are far reaching, leading

to no less than the thorough purification of human nature of its inherited

toxins and the complete emancipation of consciousness from its hedonic

conditioning. The usefulness of mindfulness to the modern psychotherapist

and researcher is being discovered and creatively explored in ever new ways

each day, as will be amply demonstrated in the rest of this book.

References

Nanamoli, B., & Bodhi, B. (1995).
The middle length discourses of the Buddha
.

Boston: Wisdom Publications, p. 208.

Olendzki, Andrew. (2008).
The real practice of mindfulness
. Buddhadharma, The

Practitioner’s Quarterly. Fall 2008, p. 50.

3

The Neurobiology of Mindfulness

Michael T. Treadway and Sara W. Lazar

The mind precedes all things, the mind dominates all things, the mind

creates all things.

Buddha

As Western culture has become more aware of Eastern spiritual traditions,

scientists have been increasingly interested in verifying the anecdotal claims

from expert meditators regarding mindfulness practice. For almost 50 years,

the practice of meditation and mindfulness has been studied by Western neu-

roscientists looking to better understand its phenomenology, neurobiology,

and clinical effects. In this chapter, we provide an overview of current neu-

robiological research on mindfulness and meditation practices, including key

findings, methodological issues, and clinical implications. It is not our intent

to provide a complete review of this vast and diverse body of work; for exten-

sive reviews of the neurobiological literature, please see
Cahn and Polich

(2006), Austin (1998,
1998),
and
Murphy, Donovan, and Taylor (1997);
for reviews of the clinical literature, see
Lazar (2005)
or
Baer (2006).
The goal of this chapter is to review the most recent literature and orient the reader

to this developing research area and its implications for mindfulness-based

interventions.

Although all forms of meditation increase one’s capacity to be mindful, the

Buddhist traditions place a particular emphasis on cultivating mindfulness.

Therefore, it is these traditions that have served as the primary source for the

mindfulness techniques that are now incorporated into Western psychother-

apeutic practices such as DBT, ACT, and MBCT (mindfulness-based cognitive

therapy). As the focus of this chapter is mindfulness, the term “meditation”

in this chapter will be used to denote the Buddhist meditation practices that

cultivate mindfulness, unless otherwise specified.

Studying Mindfulness

The goal of the neuroscientific investigation of mindfulness meditation is

to understand the neural systems that are utilized to achieve meditative

states and also to determine the effects that regular practice of mindful-

ness has on brain function and structure. Meditation is associated with both

state and trait-like effects. State effects refer to changes that occur in indi-

viduals while they actively meditate. In contrast, trait-like changes occur

gradually over time as a consequence of sustained meditation practice and

persist throughout the day. Trait-like effects are thought to result from stable,

45

46

Michael T. Treadway and Sara W. Lazar

long-term transformations in brain activity and structure. When studying

trait-like versus state effects, scientists can ask different questions, all of

which may have clinical applications. Understanding state effects will help

elucidate why mindfulness may be useful within a therapy session when deal-

ing with painful memories or sudden bursts of emotion. Conversely, under-

standing the long-term effects will help identify why mindfulness is useful

for treating chronic conditions such as depression and general anxiety (see

Chapters 10 and 12).

One primary challenge of studying the state effects of meditation is the

complexity of meditation itself (see also Chapter 2). Typically, when scien-

tists want to investigate the neural systems that underlie a certain skill, they

use tasks that are very simple, repetitive, and easy to monitor, such as reac-

tion times to stimuli. By keeping tasks simple, it is easier to isolate specific

areas of the brain that are involved in task performance. In contrast, medita-

tion is highly complex and variable from moment to moment. In one instance

a person may be concentrating deeply on the breath, and in the next they

suddenly recall an errand to run; a few moments later they may become

mindful of having just been distracted and then return focus to the breath,

but then a few moments later an image from their childhood suddenly pops

up and so forth. Focusing on the breath, remembering an errand, recogniz-

ing that you have become distracted, and seeing an image from the past, all

involve discrete brain systems. Should all of those systems be considered part

of the “meditative state?” Or should the term “meditative state” include only

those brain regions that are active when we are focused on the breath? How

can scientists tease apart those moments of clear focus from those moments

of being distracted? Our experimental technology is not yet capable of deter-

mining when the mind switches between these mental events.

In the sections that follow, we review recent findings on neurobiological

studies of mindfulness mediation. The first two sections summarize the pri-

mary findings regarding the effects of meditation on attentional ability, cog-

nitive and emotional processing, and brain function and structure. The third

section addresses some recent studies pointing toward possible mechanisms

of action involved in meditation, and the final section addresses the possible

ramifications of these findings for clinical interventions.

Cognitive and Behavioral Effects of Mindfulness

According to the claims of experienced meditation practitioners, increased

levels of practice are accompanied by a heightened sense of awareness and

enhanced capacity for deep concentration both during meditative states and

throughout the day. Scientists have therefore reasoned that experienced med-

itators should show better performance on high cognitive-demand attention

and concentration tasks than individuals without meditation and mindful-

ness training. In this section, we summarize several key findings regarding

the cognitive and behavioral effects of mindfulness meditation training.

Studies of Attention

Drawing from the self-reported claims of meditation practitioners, changes

in attentional resources have been the focus of several recent studies. In the

Chapter 3 The Neurobiology of Mindfulness

47

cognitive psychology literature, “attention” is a blanket term that may be

used to describe all or some of a set of discrete sub-processes that collec-

tively underlie our ability to attend to different stimuli. Examples of these

sub-processes include alerting (becoming aware of a stimulus, such as to

a car horn honking), sustained attention, and conflict monitoring (remain-

ing focused on a stimulus despite the presence of a distracting/conflicting

stimulus). In one recent study, Jha et al. (2007) sought to compare these

three attentional sub-processes across three participant groups: a group of

experienced meditation practitioners before and after an intensive 1-month

retreat, a group of novice meditators before and after an 8-week MBSR

course, and a control group tested 8 weeks apart. They found that both the

retreat and MBSR groups showed improvements on the sustained attention

task over the course of the intervention, relative to the control group. The

other two types of attention did not change, showing the specificity of the

results.

Another recent longitudinal study sought to investigate whether intense

meditation practice during a 3-month silent retreat would increase an indi-

vidual’s attentional capacity. When two stimuli are presented in quick suc-

cession, people generally have trouble identifying the second stimulus, a

phenomenon known as “attentional blink.” This reduced ability to process

two stimuli in close temporal proximity is thought to be an index of stimuli

competition for limited attentional resources
(Shapiro, Arnell, & Raymond,

1997).
Researchers found that meditators showed less of an attentional blink response after the 3-month retreat. In addition, there was a group by time

point interaction, confirming the hypothesis that meditators improved more

during the 3 months than the non-meditating controls. Consistent with

theses behavioral findings, simultaneously recorded electroencephalography

(EEG) signals showed that individuals who performed best on the atten-

tional blink task also exhibited the least amount of brain activity at the onset

of the first stimulus. This suggests that these individuals were effectively

able to reserve attentional resources for the second stimulus
(Slagter et al.,

2007).

Finally, in an earlier study,
Valentine and Sweet (1999)
sought to directly compare the effects of mindfulness and concentration meditation on sustained attention in both novice and experienced practitioners of Zen medi-