Transcript the Powerpoint Presentation

Neural Bases of Meditation,
Emotion Regulation
and Self-Processing
Philippe Goldin, PhD
Clinically Applied Affective Neuroscience
Stanford University
Goal
Regulatory
Cortical System
Emotion
Limbic System
BrainBehavioral
Mechanisms
Social Anxiety
Understand and
Reduce Suffering
Meditation
Methods
Mental States
Fly stuck on sundew leaves
Fluid mountain stream
Attention-based
meditations:
-Focused Attention
- Open Monitoring
Lutz et al. 2008
Lutz et al. 2008
Focused Attention
• Directing and sustaining attention on a selected
object (e.g. breath sensation)
• Detecting mind wandering and distracters (e.g.
thoughts, images, memories, emotions)
• Disengagement of attention from distracters and
shifting of attention back to the selected object
• Cognitive reappraisal of distracter (e.g. ‘just a
thought’, ‘it is okay to be distracted’)
Contemplation
• Focused attention on the breath
Open Monitoring
• No explicit focus on any object
• Non-reactive meta-cognitive monitoring
• Awareness of automatic cognitive and
emotional interpretations of experience
Contemplation
• Open monitoring of any and all experience
Mindfulness Based Stress Reduction
(MBSR)
• Formal meditation practice
– Breath focused
– Body scan
– Attention shifting to different
sensory modalities
– Compassion / Loving-kindness
• Informal meditation practice
– Meaningful pauses
• Yoga / Stretching
Many Types of Meditation
• Concentration
–
–
–
–
Focused attention
Image (visualization)
Sound (mantra)
Open monitoring
• Analytic-linguistic-reasoning
– Death meditation
– Generating loving-kindness,
empathy, compassion
• Emptiness/Shunyata
– Dissolving mistaken view of nature
of self
Definition of Mindfulness
“Paying attention
in a particular way,
Attention
on purpose,
Intention, motivation
Alerting
re-orienting,
executive control
in the present moment, Experiential approach
and non-judgmentally” Attitude
Acceptance, Curiosity
Kabat-Zinn, 1994, p. 4
In the Present
Process Model of
Mindfulness Meditation
Attention
Intention
Stress / symptom
reduction
Follow
Breath
Concentration
Focused
Open
Increase well-being
Self-exploration
Attitude
Self-Judgment
Self-Criticism
Kindness
Curiosity
Regain
Attentional
Focus
Distraction
Attention
Ruminate / Worry
Mindless wandering
Fantasizing
Mechanisms of
Mindfulness Training?
• Emotion Regulation
• Attention Regulation
• Self-Referential Processing
Neural Model of Emotion Regulation
Regulatory
Systems
+/Affective state
Fear, Anxiety
Threat
Self
Regulatory
Cortical System
Language
Emotional Reactivity
Limbic System
Functional Magnetic Resonance
Imaging
Levels of Brain Analyses
fMRI Brain Activation
Negative
Self-Belief
Neural Firing
Neural Circuit
People think
I am socially
incompetent
Amygdala
Oxygenated
hemoglobin
↑CBV, CBF, OxyHb, BOLD signal
Tasks
• Emotion Regulation
of Negative Self-Beliefs
• Self-Referential Processing
of positive and negative social traits
Social Anxiety Disorder
Social Anxiety Disorder
• Lifetime prevalence: 12.1%
• 4th most common psychiatric condition
• Early onset
– 80% before age 18 (Otto et al., 2001)
– Usually precedes development of
depression, substance abuse, other
anxiety disorders
– Highest high school dropout rate for all
anxiety disorders
Autobiographical Social Situation
At a job I had about 6 years ago, I was
supposed to introduce myself to a group of 5
or 6 new employees. The president of the
company was speaking first, and then I was
supposed to say a few words. My anxiety grew
to such a heightened level right before I had to
get up to speak, that I needed to leave the room
and the building. I had to take a walk for about a
half an hour before I even got up the courage to
go back into the building to admit to my manager
what I had done and how I had failed.
Client x
Negative Self-Beliefs
1. Something is wrong with me
2. I am inferior compared to others
3. People think I’m an idiot
4. I am going to blush and make a fool of
myself
Contemplation
• Lean back
• Rest in your mind & body
• Source of suffering? Deep held distorted
self-belief
• What would freedom look like for you?
Study Structure
Baseline Assessments
MBSR
Wellness
CBT
Waitlist
Cognition
Behavior
Emotion
Post-Assessments
Follow-Up Assessments
Emotion Regulation Task
Autobio
Social
Situation
60s
Reactivity to
Implement
Negative
Regulation
Self-Belief
12s
Rate
Rate Strategy
3s
12s
Rate
Rate
3s
Meta-cognitive shift to
observation
Mindful Awareness
Count backwards from
168 by 1s
Attention Distraction
Re-interpret the meaning
of the belief
Cognitive Reappraisal
Emotion Regulation Results
Regulation
threat
modulation
Emotion
Limbic System
% Reduction in Negative Emotion
Improved Emotion Regulation
Post-MBSR
0
-5
-10
-15
-20
-25
-30
-35
-40
-45
-50
Cognitive
Reappraisal
Mindful
Awareness
**
Attention
Distraction
**
**
** p<.01
Clinical Symptom Results
Pre- to Post-Intervention
Improvement
Pre-to-Post Reduction
5
CBT
MBSR Waitlist Wellness
0
-5
-10
-15
***
**
-20
*
*
*
-25
***
-30
BFNE
-35
-40
***
LSAS
BDI
* P<.05, ** P<.005, *** P<.001
Neural Results
Regulatory
Cortical System
Emotion
Limbic System
REACT Negative Self-Beliefs
• Wellness
– No changes
• MBSR
– Right DLPFC
– Bilateral posterior Insula
– Left Inferior Parietal Lobule
Cluster threshold:
Voxel p<.005 & vol>162 mm3
Cluster p<.01
R
RR
BOLD % Signal Change Relative to Neutral
L
REACT: Amygdala
24 React Baseline
35 SP Baseline
y=-4
0.2
0.1
0.0
-0.1
-0.2
0s
1.5s
3s
4.5s
6s
7.5s
9s
10.5s
12s
-0.3
-0.4
-0.5
-0.6
-0.7
-0.8
Negative Self-Belief
Emotion Rating
L
BOLD % Signal Change Relative to Neutral
REACT: Amygdala
35 SP BASELINE
y=-4
15 SP Post-WELLNESS
0.2
0.1
0.0
-0.1
-0.2
0s
1.5s
3s
4.5s
6s
7.5s
9s
10.5s
12s
-0.3
-0.4
-0.5
-0.6
-0.7
-0.8
* p<.05
Negative Self-Belief
Emotion Rating
L
BOLD % Signal Change Relative to Neutral
REACT: Amygdala
y=-4
0.2
0.1
0.0
-0.1
-0.2
0s
-0.3
1.5s
3s
4.5s
6s
7.5s
9s
10.5s
12s
*
-0.4
-0.5
-0.6
15 SP Post-MBSR
-0.7
-0.8
* p<.05
Negative Self-Belief
Emotion Rating
Neural Substrates of Attention
Alerting
Orienting
Executive
Control
Michael Posner & Jin Fan
http://www.sacklerinstitute.org/~jinfan/
MBSR Enhanced
Attention Regulation
L
Z = 42
R
X= -2
Y = 27
Post > Pre-MBSR during
Mindful Awareness vs. Attention Distraction
BOLD % Signal Change relative to Neutral
MINDFUL AWARENESS
amygdala
35 SP BASELINE
L
y=-4
15 SP Post-WELLNESS
0.4
0.2
0.0
-0.2
0s
1.5s
3s
4.5s
6s
7.5s
9s
10.5s
12s
-0.4
-0.6
-0.8
-1.0
-1.2
-1.4
-1.6
* p<.05
Negative Self-Belief
Emotion Rating
BOLD % Signal Change relative to Neutral
MINDFUL AWARENESS
amygdala
L
y=-4
0.4
0.2
0.0
-0.2
0s
1.5s
3s
4.5s
6s
7.5s
9s
10.5s
12s
-0.4
-0.6
*
-0.8
-1.0
-1.2
15 SP Post-MBSR
-1.4
-1.6
* p<.05
Negative Self-Belief
Emotion Rating
Summary of MBSR for Social Anxiety
Cognitive
Regulation
Attention
Regulation
Sensory/
Visceral
Emotion Reactivity
Limbic System
Negative
Self-Beliefs
Cognitive Reappraisal of
Negative Self-Beliefs Post > Pre-CBT
Selfregulation
Language
Attention
regulation
Contemplation
• SELF
Meta-Analysis of
Self-Referential Processing
Cortical midline structures: ventromedial prefrontal,
dorsomedial prefrontal, posterior cingulate/precuneus
Statistical analysis based on 27 PET and fMRI studies on self-related tasks
published between 2000 and 2004; Northoff et al. 2006, NeuroImage
Forms of Self Processing
• Analytic/Narrative Self
– Past-future oriented
– Fixed self-concept
– Rumination
• Experiential Self
– Present moment focused
– Continuously changing experience of self
– Reduced problems with memory,
depression, and anxiety
Watkins & Teasdale, 2003; Farb et al 2008
Self-Referential Processing Task
UPPER
case?
*
POSITIVE
valence?
REJECTED
Describes
ME?
regretful
AFRAID
embarrassed
terrific
admired
JOLLY
BRAVE
or
loved
1.5 s
coward
3s
3s
15 s
19.5 s
Self-Referential Processing
15 Healthy Controls
Cluster threshold:
Voxel p<.001 & vol>162 mm3
Cluster p<.01
16 Social Phobics
MBSR Modifies
Self-Referential Endorsement
% Self-Endorsement
90
Positive
80
Negative
70
60
50
40
30
20
10
Pre
MBSR
Post
Time x Valence, F=5.60, p<.05, partial eta2 = .41
Mindfulness Training and Self-View
Reduction in neural bases of analytic/narrative self
Linguistic
processing
Cognitive
appraisal
Selfreferential
processing
Summary of
Mindfulness Training Effects
Cognitive
Regulation
Attention
Regulation
Self
Language
Emotion Reactivity
Limbic System
Threat
Regulatory
Cortical System
Emotion
Limbic System
=
Psychological
Flexibility
Empathy/Compassion
Neuroscience is investigating:
- how we understand another person’s mind
- take their perspective and experience emotional resonance
- neural bases of training in empathy/compassion
"I feel the capacity to care is the thing which gives
life its deepest significance." – Pablo Casals
Paul Ekman’s
Model for Compassion
Identical
Reactive
Emotion
Resonance
Emotion
Recognition
Heroic
Compassion
Sentient
Compassion
Global
Compassion
Familial
Compassion
Motor Imitation in Infants
Meltzoff, AN, Moore MK. Imitation of facial and manual gestures by human neonates.
Science, 1977;198.
Neural Bases of
Understanding Others’ Pain
• Cognitive perspective
taking
- mental representation of
other; social cognition
• Empathy
- in responses to pain,
disgust, taste, and touch
- emotion, sensation
MPC, medial prefrontal cortex; ACC, anterior cingulate cortex; AI, anterior insula;
SII, secondary somatosensory cortex; TP, temporal poles; STS, superior temporal
sulcus; TPF, temporo-parietal junction.
Hein, Singer, Current Opinion in Neurobiology. 2008
Clinically Applied Affective Neuroscience
Laboratory & Collaborators
Mentors
Stanford University
James Gross
Gary Glover
UC San Diego
Greg Brown Murray Stein John McQuaid
Rutgers University
Marsha Bates
Brenna Bry
Funding
Thank you for your attention
Resources
• For social anxiety disorder
contact the CAAN lab:
– Call 650-723-5977
– Email: [email protected]
– Visit: www-psych.stanford.edu/~caan
Meditation
• Spirit rock: http://www.spiritrock.org
– Check out: Sitting Groups Led by Spirit Rock
Teachers throughout the Bay Area
• SF Zen Center
– http://www.sfzc.org/
• SF Buddhist Center
– http://sfbuddhistcenter.org/
Study Structure
Baseline Assessments
MBSR
Wellness
CBT
Waitlist
Cognition
Behavior
Emotion
Post-Assessments
Follow-Up Assessments
Clinically Applied Affective Neuroscience
Psychology Department
Stanford University
650-723-5977
[email protected]
www-psych.stanford.edu/~caan
YouTube talks:
Neuroscience of Mindfulness Meditation
Neuroscience of Emotion
Study Structure
Baseline
Assessments
MBSR
Wellness
Assessments
Minutes per Week
Home Practice
Mindfulness
200
180
160
140
120
100
80
60
40
20
0
Minutes per Week
Formal
Body Scan
Informal
Yoga
Total
Aerobic Exercise
200
180
160
140
120
100
80
60
40
20
0
Group
Individual
Total
Autobiographical Social Situations
Autobiographical Situation Questions
Very Much
9
SP
HC
*
Mean Rating
8
7
6
5
4
3
2
Not At All1
1
2
3
4
1. How vividly can you re-imagine or re-experience that situation NOW?
Question
2. How much humiliation, embarrassment
or shame did you feel when you
experienced this situation when it happened?
3. How much humiliation, embarrassment or shame do you feel NOW when you
recall this situation?
4. How much do you actively avoid situations similar to this event?
* p<.05
Error bars
= SD
Negative Emotion Ratings for
Negative Self-Beliefs
Negative Emotion
5
4
p2=.58
React
Mindful
Observe
3
p2=.41
2
1
35 SP
Baseline
15 SP
Post-MBSR
p2 = partial eta2 effect size measure
15 SP
Post-WELLNESS
Social Anxiety Symptoms
Liebowitz Social Anxiety Scale Total
90
Time1
Pre
Time2
Post
85
80
LSAS
75
***2
p =.50
70
65
60
55
50
MBSR
Wellness
*** P<.001
Depression Symptoms
Beck Depression Inventory-II
18
16
14
BDI
12
Time1
Pre
*
Time2
Post
p2=.31
10
8
6
4
2
0
MBSR
Wellness
* P<.05
Marcus Aurelius
(Meditations)
167 A.C.E.
If you are distressed by anything external [or internal],
the pain is not due to the thing itself,
but to your estimate of it;
and this you have the power to revoke at any
moment.
Cognitive-Behavioral Therapy
Cognitions
Self
Behaviors
Regulatory
Cortical System
Emotions
Emotional Reactivity
Limbic System