Transcript The Mindful Brain - International Centre for Child Trauma Prevention

The Mindful Brain
self-regulation and social engagement
Dr Terry Myers
Senior Lecturer (retired) in Cognitive Science
University of Edinburgh
[email protected]
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Introduction
• The study of mindfulness has a long history within the contemplative
tradition, and has been cultivated through a number of practices,
including meditation. Mindful awareness now has a central place also in
clinical practice. And, motivated by a shift in focus from pathology to wellbeing, there is a resurgence of interest in it as a discipline for all who wish
to enhance their life experience by being fully in the present.
• However for most people who have experienced trauma, particularly from
infancy, their ability to be in the present is severely compromised, as they
are continually being drawn back into their past. In order to live in the safe
present, and to benefit from therapy, their mastery of mindfulness is a key
issue.
• Being self-aware is critical for making rational life decisions, and being
‘mindfully aware’ of each other is foundational for living harmoniously
together. Understanding mindfulness therefore, needs to be brought into
the disciplinary framework of systematic inquiry.
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Introduction ctd
• Through brain imaging research, neuroscientists are now able to ground
the inquiry in measurable activity of the brain. So what are they beginning
to find out?
• We will consider some of the recent research on mindfulness, looking in
the first half at the cultivation of mindfulness through meditation and
other techniques, and at the role of ‘body maps’ and feelings in the
formation of conscious experience. In the second half we will focus on the
crucial role of affect regulation in the development of positive social
engagement and empathy. Throughout we will note the brain areas that
are active during mindful activity as we attempt to form a dynamic picture
of the mindful brain.
• But first, what do we mean by ‘mindfulness’?
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Mindfulness and Meditation
• ‘Mindfulness’ in common usage: “paying attention or taking
care” as in listening closely to what is being said, driving
carefully. The key element is direct experience of what is in
the present, not doing something on ‘automatic pilot’, while
thinking about something else.
• Awareness through paying attention, on purpose, in the
present moment, and non-judgmentally to the unfolding of
experience moment-by-moment (Kabat-Zinn, 1990) (i)
• Five facets of the mindfulness construct used in the clinical
field: describing; acting with awareness; being non-judging;
non-reactive; observing. The first four are independent
facets; observe overlapped with the others except for people
who practiced meditation (Baer et al, 2006) (ii)
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Mindfulness in the contemplative tradition
• Buddhists see the undisciplined mind as unbalanced, swinging
between excitation and laxity. Cultivation of attentional
stability has therefore, a central place within its tradition
• Detailed instructions for achieving focussed attention in a
discipline known as shamata (sha-ma-ta), meaning stillness, is
practiced by Tibetan Buddhists (Wallace, 2007)
• The contemplative reaches attentional balance through a
series of stages by progressively rooting out more subtle
forms of the two mental obstacles: agitation and dullness
• Ultimately the contemplative achieves the primary state of
‘contentless awareness’, bhavanga, finding that the nature of
this state of consciousness is loving kindness
• From bhavanga arises empathy and compassion
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Mindfulness in neuroscience
• Neuroscience recently turned its attention to mindfulness. To
get a glimpse of the phenomenon they seek to understand,
100 researchers were provided training in Vipassana
meditation, focussing on breathing, at a week’s silent retreat
• Dan Siegel, a psychiatrist and participant at the retreat,
reported that it was difficult at first to just observe one’s
breathing. The mind keeps introducing thoughts that take the
attention away from the here-and-now activity of breathing
• He devised for his therapy clients a reflective exercise to
enable them to clearly discriminate between the images,
thoughts and feelings that intrude in this way and the self that
observes them
• Disidentification, the realisation that we are not our thoughts,
is a state of being in which we can decouple from our habits
of mind.
DEMONSTRATION
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Mindfulness in neuroscience ctd
• With diligent practice the student of mindful awareness training
gains an ability to regulate thought and feeling and to just be
his/her ‘ipseitious self’(Lutz et al., 2007)
• “Ipseity is the minimal subjective sense of “I-ness” in experience,
and as such, it is constitutive of a ‘minimal’ or ‘core’ self. By
contrast, a narrative or autobiographical self encompasses
categorical or moral judgement, emotions, anticipation of the
future, and recollections of the past (Legrand, in press).
• Is ipseity the core state of mindful awareness? And is it the core
state of consciousness ? How does neuroscience approach these
questions?
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Embodied Self
• Antonio Damasio (1999) offers a biological base-line for considering
the nature of self and consciousness. Although language plays a
key role in the formation of the auto-biographical self, with its rich
narrative content, the consciousness that underpins this, core
consciousness, is non-verbal.
• He starts from the position that the “roots of consciousness” are
feelings and the “sense of self” has a preconscious biological
precedent, the proto-self. (i)
• The proto-self is the foundation on which core consciousness is
built. It is not itself conscious.
• It is a collection of neural patterns that continuously map (record)
and regulate the body’s internal state, keeping it within safe limits
of variation of the environment. This is the prior life-preserving
function of the proto-self. (ii)
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Structures implementing the proto-self
• Brain-Stem Nuclei: regulate current body state and map body
signals; connect to higher levels of the CNS, and via spinal chord
pathways, to the furthest reaches of the body-The highest input to
this structure arrives, via the trigeminal nerve at roughly the
position shown, from the facial areas. The vagus nerve, also shown,
brings signals from the viscera: heart, lungs and stomach
• Hypothalamus: contributes to the mapping of the body by
registering the current state of the internal milieu (glucose, water,
pH, ions, hormones) which it helps regulate
• Basal Forebrain: interconnects the brain-stem nuclei and
hypothalamus and constitutes their extension into the forebrain
• Insular and Somato-sensory Cortices: these hold (in the RH mainly)
the most integrated representation of the current internal state of
the organism at the level of the hemispheres (along with the
invariant design of the musculoskeletal frame).
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The proto-self and somatosensory system
• The proto-self represents the body perspective of the individual; it
provides the frame of reference for the experiencing of objects and events
in terms of the body changes they provoke in the organism.
• Example: A car is careering suddenly in your direction; you move head
and neck as you track its course, and a fear response is provoked. This
manifests as increase in blood pressure, heart rate, breathing and
activation of the muscles for flight. The changes in body state are mapped
by the brain. For an individual observing the incident from an upstairs
window the event impacts differently on the structures that implement
the proto-self.
• The body maps (i) of you and the observer will clearly differ, reflecting the
difference in body perspective, and the conscious experience arising from
them will be correspondingly different.
• Body maps are formed by the somatosensory system. This is a
combination of several subsystems, each conveying information about
different aspects of the body state. There are three fundamental divisions:
internal milieu and viscera;
andauthors
musculoskeletal, and fine touch
Not vestibular
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The somato-sensory system
• Internal Milieu and Visceral Division: maps changes in the chemical
environment of cells throughout the body, signaling the state of
the smooth muscles abundant throughout the viscera and under
autonomic control: stomach; skin surrounding the whole body (the
largest of the visceral organs: contains temperature and
communicative emotional touch receptors). The generic term for
sensing changes in this internal environment is interoception.
• Vestibular and Musculoskeletal: this division monitors balance and
body position in space, and registers the state of the striate
muscles joining moving parts of the skeleton, the bones. Sensation
arising here is described as proprioception.
• Fine Touch: one of the five primary senses, arising from a different
type of touch receptors from those of the first division. They enable
external objects to be experienced directly on the basis of signals
generated at the body surface.
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Somatosensory system ctd
• The divisions of the somatosensory system can work fairly
independently. They can also work in close collaboration.
• Example: When you lift your baby out of the bath and cradle her in
your arms, your movements for lifting and cradling are regulated by
the second division (vestibular and musculoskeletal); the infant’s
wet skin activates the fine touch system that guides the careful
movements of your hands. And the humoral and visceral reactions
that constitute the pleasurable response to the close contact with
your loved one are mediated by the first division (internal milieu
and visceral) concerned with your own internal environment.
Under normal conditions this division is on duty all the time, even
in deep sleep, and the brain is also being continually informed
about the musculoskeletal system.
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Building core consciousness
• When an individual engages with an object the proto-self changes
in a way determined by the properties of the object from the
perspective of the individual engaging with it.
• ILLUSTRATION You are sitting relaxed and listening attentively when
suddenly I throw you an object, say, a large beach ball. You respond
by tracking the object and making movements that change your
posture to one that will enable you to catch the ball. Minimally this
requires adjustments to the vestibular and musculoskeletal division
of the somatosensory system and to the level of arousal, in the
internal and visceral division, that readies you for the catch. Let’s
try it, with a large, imaginary beach ball.
• A little reflection will reveal that your body adjustments were
tailored to the properties of the object that are relevant to catching
it (its size, shape, weight..) and the dynamic parameters of its
movement towards you. The adjustments to be made would be
different if I threw a different object (say, an imaginary rag doll).
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Let’s try it
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Building core consciousness ctd
• The adjustments are also calibrated to the starting state of
the proto-self. Sitting upright you see the object moving to
your right, you shift your posture, changing the vestibularmuscoloskeletal part of the body map
• In this way, the properties and parameters related to catching
the object from the body perspective of the individual modify
the body maps of the proto-self (i)
• This second-order process, of object-related modification of
body maps, is what generates core consciousness: ‘the feeling
of what happens’, and enhances the image of the object
bringing it into focal awareness. (ii)
• The second-order maps are generated by neural structures
capable of receiving information from body and object maps:
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superior colliculus, thalamus,
and anterior cingulate cortex
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Structures implementing core consciousness
• The superior colliculus turns the eyes towards the object to be
engaged.
• The lateral pulvinar in the thalamus locks on to the object, sending
information about it to the relevant areas of the cortex.
• The thalamus coordinates the cortical and sub-cortical processes
that come together in the generation of consciousness.(i)
• The anterior cingulate cortex receives massive inputs from the
somatosensory system, is involved both directly and indirectly in
the complex adjustments which re-set the maps of the proto-self,
and is crucially involved in processes of attention and emotion. It
plays a key role, together with the thalamus, in generating
consciousness. (ii)
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Affect Regulation
• Affect regulation is a defining aspect of mindfulness. When
regulated, feeling and emotion play an essential role in the rational
decision making that is conducive to social harmony. Helen has
written that “emotion is not the enemy of reason but its
powerhouse” (H.Myers, 1990).
• The ventromedial PFC , in each of the frontal lobes, is dedicated to
feeling and emotion. Bilateral damage here can seriously limit the
capacity for rational decision making in the personal and social
domain.
• Example: Elliot, following surgery to remove a tumour, could not
make rational decisions, and no longer had the gut feelings that
would tell him whether a business associate could be trusted. He
went bankrupt (a credulity crunch?). Normally, “When a bad
outcome connected with a given response option comes into mind,
you experience an unpleasant gut feeling” (Damasio, 1994).
Because the feeling is about
the body and marks the option coming
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to mind, Damasio called it a somatic
Non-reactivity
• Emotion then, is the driving force behind socially appropriate
reasoning. But evolution has delivered a brain with an
emotion generating system that can over-power its cognitive
system, disposing the individual towards reactivity, and even
trauma. The amygdala can trigger the fear response ahead of
conscious awareness and the appraisal of its appropriateness.
How is the flexibility of feeling that is necessary for social
harmony to be achieved?
• Affect may be mindfully regulated through the integrative
function of the middle pre-frontal regions (MPFR) of the
cortex, mainly in the right hemisphere, together with the
social engagement function of the vagal system.
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Non-reactivity ctd
• Affect regulation comes about through interconnection of the
amygdala with the orbital medial prefrontal cortex (OMPFC),
which can moderate the response of the amygdala.
• The OMPFC-amygdala network, which is shaped by
experience, “encodes our learning history of what is safe and
dangerous including our attachment schema” (Cozolino,
2007). This enables us to act in a measured way rather than
simply react.
• The orbital medial PFC receives information from the body
and the external environment. This information is relayed to
the ventral medial PFC, which connects with many parts of
the limbic system, whereby it can “mediate the integration of
the visceromotor aspects of emotion with information
gathered from the internal and external environments”
Gusnard and Raichle (2001). This would furnish an explicit
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mechanism for the formation
of somatic markers of events.
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Affective style and resilience
• The way people handle emotion, affective style, expresses consistent
differences in affect regulation.
• Richard Davidson (2000, 2004) examined the way that mindfulness
training can shift affective style towards non-reactivity. Non-reactivity
expresses a central aspect of resilience, which he defines as the
“maintenance of high levels of positive affect and well-being in the
face of adversity”. Negative affect when it occurs does not persist in a
resilient individual.
• Affective style has deep roots going back to early caregiver-offspring
relationships. But resilience can be acquired throughout the life-span
through positive social experiences. Siegel suggests that mindfulness
as a form of “attention and care focused on oneself” encourages an
approach mindset in which feelings become flexible and affective style
is shifted towards resilience. With this we gain the capacity to
rebound from negative states, not to eliminate them from the rich
spectrum of human experience.
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Development of affect regulation
• The development of a healthy affect regulation system requires an
emotionally stimulating environment and protection from intense,
prolonged, and overwhelming experiences. Whilst emotionally
stimulating experiences promote brain growth, overwhelming affect and
prolonged stress lead to the loss of the neurons required for building the
cortical-limbic circuitry associated with adaptive affect regulation.
• PET scans of babies’ brains show that the areas correlated with bodily
regulation ( brain stem), sensation (thalamus), and movement
(cerebellum) are very active. Connections are being formed and functional
circuits created among cells that are active together.
• Coupled with this activity is a neural sculpting process referred to as
apoptosis or programmed cell death, the function of which in the
immature brain is to remove cells and connections that are not being
used, thereby improving the efficiency and organization of the others.
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Development of affect regulation - ctd
• Apoptosis facilitates differentiation of function, removing for example,
connections between the auditory and visual cortices which would
otherwise mean ‘hearing’ colour say, and ‘seeing’ sound. The downside of
apoptosis is that the process can be distorted by abuse and neglect, which
inhibit the normal maturation of circuits vital to affect regulation. The
baby is left with a loss of neurones but no specialisation, and thus a
permanent loss of affective capacity and regulation.
• Development of a well regulated affect system requires repeated
experiences of moving back to a balanced state following short periods of
dysregulation, in the safe, stimulating environment provided by positive
parent-child interactions. These experiences of parent-guided recovery
from affective imbalance become encoded as implicit memories of
positive state transitions and dispose the growing child toward selfregulated affect (see Cozolino, 2007).
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Applying the vagal brake
• Successful engagement with others plays the key role in the development
of affect regulation. Stephen Porges has proposed a polyvagal theory of
social engagement (Porges 2001, 2003).
• According to this, the vagal system has evolved into three separate
autonomic subsystems: the ‘vegetative’ vagus, which has an immobilizing
role, and is part of the parasympathetic system; the fight-flight,
mobilizing system, which depends on the sympathetic branch of the ANS;
and the social engagement system, also referred to as the “smart” vagus.
• The smart vagus exerts a calming influence by inhibiting the
phylogenetically older sympathetic-adrenal system that would otherwise
trigger the fight-flight response.
• Beginning in the brain stem it projects, independently of the spinal chord,
both sensory and motor fibres that enable the brain to monitor and
control the functions of organs and systems throughout the body.
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Applying the vagal brake - ctd
• The myelinated smart vagus can rapidly alter the vagal tone of the heart’s
pacemaker, which is an inhibitor of heart rate. When the vagal tone is
high the inhibitory effect is strengthened and the vagus acts as a brake on
the heart rate. When it is low there is reduced inhibition of the
pacemaker and the heart rate increases. Accordingly, the ‘vagal brake’ can
rapidly act to calm (tone high) or mobilize (tone low) the individual.
• By modulating visceral state the vagal brake “enables the individual to
rapidly engage and disengage objects and other individuals and to
promote self-soothing behaviours and calm behavioural states” (Porges,
2001). This addition to our autonomic control system allows us to stay
engaged in cooperative relationships with others, despite transient
disagreement and conflict, without requiring sympathetic arousal or
adrenal activation. It is the evolution and development of this social
engagement system that has promoted courting and sustained pairbonding, in a context of “love without fear” (Porges, 1998).
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Applying the vagal brake - ctd
• Development of the engagement system and fine tuning of the vagal brake
to regulate affect appears to depend on the quality of attachment
relationships in early childhood. The shaping and tuning of the smart
vagus is one way that early experience shapes the brain. It integrates with
cortical and limbic structures in the regulation of experience and
behaviour. ADHD may in some cases at least, result from insufficient vagal
tone .
• In summary: Higher vagal tone is correlated with positive social
engagement; ability to self-regulate; self-soothing capacity by 3 months of
age; range and control of emotional states; suppression of heart rate
variability; enhanced attentional capacity and ability to take in
information; consistent caregiver and secure attachment. Lower vagal
tone is correlated with behaviour problems at 3 years of age; emotional
dysregulation; distractability; hyperactivity to environmental and visceral
stimuli; withdrawal; impulsivity and acting out; insecure attachment.
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Empathic Attunement
• Dan Siegel has adopted in his work on interpersonal relationships
within families the concept of attunement to “examine how one
person, a parent, for example, focuses attention on the internal
world of another, such as a child.” Building on his studies of
interpersonal attunement and the self-regulatory functions of
focused attention, he goes on to suggest that mindful awareness is
a form of internal attunement.
• How might we focus on the inner world of another? Work on
social mirroring is providing some clues. Mirror neurons were
discovered while recording from individual motor cells in the
premotor area of a macaque monkey observing another
macaque engaged in a specific behaviour, such as grasping an
object with her hand. They were labelled ‘mirror’ because
they fire both when an individual is observing a particular
action and when performing
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Empathic Attunement ctd
• The observer’s sensory image of the act primes the motor system
with an “inner imitation” of it (Iacoboni, 2007). This was an
interesting finding in itself, relating back to the earlier work of
Meltzoff on our capacity as babies, within hours of birth (41
minutes even!), to imitate adults sticking out their tongues or
making happy or sad faces.
• What particularly surprised the researchers who made the
discovery of mirror neurons (Gallese et al., 1996) is that they
responded only if the observed act was for a specific purpose, for
example grasping a peanut. Mirror neurons seem to fire only when
the observer grasps the import of the act.
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Mirroring children
• Marco Iacoboni discusses some studies of the role of mirror
neurons in human learning and development. When adults watch
others moving objects, say placing toys by hand into a bucket, they
look at the bucket before it is reached; likewise when they move
the toys themselves. Year-old infants also anticipate with their gaze
where somebody else’s hand is going to place the toys.
• Six-to-seven-month old infants, however, do not. Yet, in an earlier
phase of the study it had been established (using an optical imaging
technique) that motor areas of the younger infants were activated
when watching a woman moving the toys, but not when the toys
moved ‘independently’. So mirror neurones appear to learn to
predict the actions of others, an ability not present at birth.
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Mirroring children ctd
• But mirror neurons do not make a special contribution to brain
function in virtue of their intrinsic properties. Rather their function
is due to their location in the association areas of the frontal and
parietal areas of the cortex , the mirror neuron system (MNS).
Neural networks converge here to process information from a
number of cortical and sub-cortical areas in the coordination of
cognitive and emotional experience with sensory motor behaviour.
• What role may the mirror neuron system play in the development
of social competence and empathy? Mirella Dapretto at UCLA is
engaged in a longitudal study of this question, focusing on the
turbulent years of adolescence, beginning with ten-year-olds. She
is examining the link between the mirror neuron system and the
emotion-inducing centres of the limbic system.
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Mirroring children ctd
• Observation of other people’s facial expressions of emotion is
known to activate, in adults, three key neural systems: the mirror
neuron system; then the insula that connects the mirror neuron
system with the limbic system, and finally the limbic system itself.
• The ten-year-olds gave the same pattern of activation. What does
this say about their ability to empathize with others? To answer this
question Dapretto correlated the levels of brain activity with the
children’s scores on an emotional empathy index and a social skills
scale. She found strong correlations between empathy and brain
activity during the observation of emotional expression, and also
between interpersonal competence and brain activity during the
imitation of emotional expression.. Ten-year-olds then, appear to
have already acquired the basic resources for emotional empathy.
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Resonance
• Another key aspect of social competence is resonance. Resonance
behaviours are triggered reflexively by mirror systems: for example,
looking up or yawning when others do. The resonance mechanism
is well portrayed in nature: for example, the wheeling flight of a
flock of starlings at dusk, or a shoal of fish reacting to the sudden
presence of a predator. Movement in any part of the flock or the
shoal synchronizes the whole assembly to move as a unit.
• Research with therapist-client diads has shown that therapists
unconsciously mirror the facial expressions, tone of voice, and body
postures of their clients.
• With mindful awareness we can learn to observe our own
resonance behaviours and inhibit or voluntarily emit them (Rizzolati
and Arbib, 1998).
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Feeling caringly felt
•
Operating normally below the level of awareness, mirror
systems and resonance behaviours play an unobserved role in
our attunement to the emotional states of others. Empathic
attunement originates in affective resonance within secure
attachment relationships. Attuned mothers match their
soothing behaviour to the child’s affective state, singing less
playfully to a distressed child (Milligan et al., 2003). The
emotional resonance between mother and child results in the
child spending more time in social engagement, with better
affect regulation, symbolic play, verbal intelligence and ability
to comment on feelings and inner experience (Feldman et a..
1997/99). This provides a foundation for the empathic
awareness basic to social relationships.
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Feeling caringly felt ctd
• Kohut (1984) described empathy as the attempt to experience the
inner life of another while retaining objectivity. Holding our own
perspective in mind, we imagine what it is like to be the other. That
is, being empathic amounts to maintaining awareness of our own
inner world while imagining the inner world of another. Mirror
neuron and resonance circuits combine with visual-spatial,
cognitive, and abstract networks as we try to read the other’s mind.
• Emotional empathy is perhaps, more immediate. Dacety and
Jackson (2004) propose three requirements: sharing of another’s
affect; flexible mechanisms of emotional self-regulation, and
maintenance of separate self-representation. They found that brain
activation then mirrors the affective experience of the other.
• People ‘connect’ when they mirror each other’s affect. This state of
feeling connected is what we are calling empathic attunement: each
feels caring towards and caringly felt by the other (Rodin’s ‘kiss’)
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Rodin The Kiss
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Readings
• Rita Carter 1998; Mapping the Mind
• Louis Cozolino 2006: The Neuroscience of Human
Relationship
• Antonio Damasio 1999: The Feeling of What Happens
• Marco Iacoboni 2008: Mirroring People
• Daniel Siegel 2007: The Mindful Brain
• Francisco Varela and Jonathan Shear 1999: The View from
Within
• B. Allan Wallace 2007: Contemplative Science
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