>> ALLEN: Hi everybody.
Welcome.
Today, I'm here-- my name is Peter Allen.
I'm the Director of Google University and I'd like to introduce Philippe Goldin.
Philippe, just a moment aback, his background is a Postdoctoral Researcher.
Philippe Goldin is a Postdoctoral Researcher in clinically applied Affective Neuroscience
in the Department of Psychology at Stanford.
Hold a PhD in clinical psychology from Rectors.
He also spent six years in India and Nepal studying languages, Buddhist Philosophy and
Debate, which means that he can prove you wrong in a nonviolent way in languages that
you don't even understand.
Philippe is currently doing clinical research funded by the NIH in three areas.
And here I have to read because otherwise, I'll say it all wrong.
Neuroimaging Investigations of Cognitive Effective Mechanisms in Healthy Adults and Individuals
with various forms of Psychopathology.
The Effective Mind fullness Meditation and Cognitive Behavioral Therapy on Neural Substrates
of Emotion and Attention Regulation.
And the Effect of Child Parent Mindfulness Meditation Training.
The question is, "Why does this matter?"
Philippe and his colleagues are working on understanding how meditation affects the brain.
And I can think of at least four implications for this.
One is that meditation is moving out of the realm of faith-based practice into the realm
of recognized science.
Two, as this research is better accepted, more people will practice and benefit from
meditation.
Three, you will be able to submit cost of your Zafu and Zabuton as medical expenses,
although not this year.
And fourth implication, if you haven't already, you should immediately go to go/siy and sign
up for the next round of Search Inside Yourself, Google's own mindfulness-based emotional intelligence
class.
So without further ado, please take a deep breath, focus, and join me in welcoming Philippe
Goldin whose talk today is entitled the Cognitive Neuroscience of Mindfulness Meditation.
>> GOLDIN: Wow!
Thank you so much.
That was a beautiful introduction.
So, without further a do, just thank you very much for the opportunity to be here, and to
share some ideas and open questions and suggestions, and well, let's start.
So today I'm going to speak briefly a little bit about Attention, Mindfulness and Brain
Systems, some cutting edge research where there's a huge amount of interest, both from
a clinical side, because I'm trained as a clinical psychologist, psychotherapist, and
also Neuroscience.
I'm also trained as a Neuroscientist.
But how--what really--how does the brain work, how is it plastic, how is it influenced by
different types of training?
I'm only here in front of you because there are hundreds of people who've influenced me,
some of whom are here, people who've taught me brain imaging, how to sit with patients,
how to become a husband, how to practice meditation and so forth.
So really, I'm here, but there's hundreds of other people who really, through their
kindness, that's why I can stand here in front of you.
So, in brief, I'm going to speak a little bit about Mindfulness Meditation, one particular
type of meditation practice, and then look at a clinical application: how might one type
of practice, Mindful Based Stress Reduction, be used as a clinical intervention for adults
suffering from Social Phobia or Social Anxiety Disorder?
There are many types of mediation practice.
And that's something that's very important.
The word gome in Tibetan, bavna in Sanskrit, really refers to cultivating a certain quality
of mind.
So its practices that help us cultivate a quality and there are many ways to do that.
So there's--just simply put, there are some classes of meditation practices that really
have to do with harnessing attention, focusing and developing concentration.
So, for example, breath, body, focused meditation, visualizing an image, a mantra, or listening
to a sound, or certain object list open field.
These are different kinds of meditation practices that they have different types of results.
Then there's also linguistic, analytic linguistic or reasoning, as exemplified by monks doing
analytic debate which I did when I was I India in Tibetan Buddhist monasteries and it's really,
really fun.
And this here could be taking a topic like the precious human rebirth; working here at
Google, why is that such an amazing thing; the death meditation, generating love and
kindness, these would all be objects of analytic thinking, linguistic, logic types of meditation.
And then, the gem of all, the actual medicine, well, one form of medicine is meditation on
emptiness, in Sanskrit, shunyata.
And this has to do with dissolving a mistake in view of how I exist, how we exist, and
transforming that into a view of how one exists that is a lot more fluid and healthy.
So that's another form of meditation practice that is really these two build up to doing
this.
So, in the field of clinical interventions, clinical psychology, etcetera, there's a huge,
huge bursting interest in applying eastern concepts, eastern meditation practices, acceptance,
mindfulness, into western clinical practices, interventions.
So for example, one of the most popular Mindfulness Based Stress Reduction, I believe you had
John Kabat-Zinn here recently.
So this is really fascinating because he took people who were basically coming out of pain
clinics in UMass who the doctors were like "Look, we've done surgery, we've drugged them
up with lots of medications, we've done everything we can, we're tired of them, you take them."
And he basically said "Okay, I'll do it."
And he caught a fad and created this program "Mindfulness Based Stress Reduction" to help
people with chronic, physical and emotional pain, 30 years ago.
Next year it'll be 30 years.
So he's infiltrated the medical system in a away that no one else has done to make it
legitimate, to bring techniques, to help people deal with themselves in a way that's really
concrete, fundamental.
Beautiful.
Another derivative that's really fascinating is Mindfulness Based Cognitive Therapy, literally
a hybrid of one of the best forms of psychotherapy, cognitive therapy and Mindfulness Meditation,
specifically as a treatment to prevent relapse into major depression.
So this is to help people who have three or more previous major depressive episodes, and
helping them to prevent relapse into the subsequent depressive episode.
So this has been very, very efficacious and wonderful clinical trials across three different
study--three different continents.
Another form is Dialectic Behavior Therapy which specifically incorporates Mindfulness
Meditation as one of the techniques to help people primarily with borderline personality
disorder, but it's been extended to eating disorders as well.
And then acceptance and commitment therapy is another kind of clinical practice that
is explicitly incorporating mindfulness and Buddhist's ideas without talking about Buddhism
at all.
So these are just some examples of how it's being incorporated in clinical practices right
now.
What I'm going to focus on for today is Mindfulness Based Stress Reduction as a type of intervention.
First question is what is that?
So it consist of three different components: formal meditation practice, breath focused,
body scan of sensations, being able to shift attention volitionally from different sensory
modalities, generating compassion, loving, kindness state of mind, and then there's informal
meditation practice which is just as important as the formal sitting which is 10, 15, 20
times per day, just for even one breathe.
So you can do it even right now, just shift your attention to your own breathe just for
one cycle, to breathing in and breathing out.
So we ask people to do this anytime, anywhere, any situation, multiple times a day to build
the muscle of attention, to generate the habit of checking in, dropping in.
Oops!
And then the third component is Hatha yoga, physical stretching which is also a way of
getting into the body, noticing sensation.
So this is the program, so to speak, that we used for adults with social anxiety.
Mindfulness has been shown over the past 30 years across numerous clinical studies to
be very effective and robust for reducing stress, pain, anxiety and depressive symptoms
overall.
Mindfulness Based Cognitive Therapy has been shown to be excellent as a relapse prevention,
not a treatment for major depression, but a treatment to help prevent the next depressive
episode.
What is mindfulness?
As defined by John Kabat-Zinn, paying attention in a particular way.
From the psychological side, what we think about that is, attention has many components.
Here, we're focusing on the ability to alert, place your attention on an object.
The ability, when the mind becomes distracted, to reorient, the ability to have a specific
goal and to use top down or executive control to stay on target.
All kinds of qualities that are needed to get anything done.
Doing this on purpose, meaning I have an intention, a motivation why I'm engaging in this training
of my attention.
Doing it in the present moment, meaning avoiding, avoiding now.
So it's experiential approach.
Most of our life is about avoiding, avoidance of things that are not pleasant.
Here, this is really bringing a sense of equanimity to what's changing from moment to moment to
moment without pushing away things that I don't like, pulling in things that I do like.
Embracing anything, everything.
So it's experiential approach, not easy to do.
In trying to do this non-judgmentally, meaning bringing, instead of an attitude of self-deprecation
"I really suck at this.
I'm not good at this.
I'll never learn how to meditate.
I can't stand my mind."
Instead, bringing an idea of acceptance, curiosity, openness, about what is happening in my mind,
my mental experience, my brain.
Here's a quick process model.
The intention could be simply, "I want to reduce my stress.
I want to reduce the symptoms of anxiety."
It could be that "I want to increase well-being."
Or could even be used as self-exploration and possibly even enlightenment, if that's
what you're interested in.
So for example, you could follow the breath and you're trying to develop attention, concentration
and open awareness, calm, flow, for example.
But inevitably, the mind becomes distracted, often within seconds.
In that moment, you--either can begin to ruminate, spin.
I talked about people going into a soap opera mode for hours or minutes or days at a time,
fantasizing, dozing.
These are all forms of distraction.
But then inevitably, what has to happen with awareness is to redirect, reorient attention
and to do this without sub-judgment but in fact, doing it with kindness and curiosity.
And in fact, it's when the mind is distracted and when it becomes aware and brings it back,
that's a key moment.
That's actually where a lot of learning takes place.
Mindfulness consists of, in this Japanese calligraphy, awareness, heart, mind.
And I think that's telling, trying to bring those qualities together.
What mindfulness is not, is equally important to consider.
It's not distraction, and I'll show you some data, shortly.
It's not suppression of emotional experience or suppressing showing one's emotion.
That is not mindfulness.
It's not avoidance.
It's not ruminating or spinning on something positive or negative, it's not that.
And it's not cognitive reappraisal or thinking in a way to change the meaning of something
that's going on.
It's not a logic thinking language process.
Some of the potential mechanisms for mindfulness has to do with decentering, disidentifying
from the contents of mind.
So as I have thoughts, sensations, images, memories, those are events that are occurring
but they're not me.
So this is decentering or disidentifying.
Another possible mechanism is developing attentional focus, harnessing the ability to place and
maintain attention.
Regulation of emotion.
Obviously as one trains, this can harness your attention, things that would normally
distract or evoke emotional off-balance will occur at less and less frequently.
Changing in how we view our self arises inevitably, implicitly, through doing this kind of practice.
And then, it's also been thought that negative self-focused spinning or ruminating is decreased.
So, this is a study that my wife and I did awhile ago where literally, just in a sample
of people with mixed anxiety depression; we found that, compared to a wait-list control,
no change.
We found that people with mind--who did the mindfulness course, actually showed a significant
reduction, post mindfulness-training, compared to a wait-list.
In negative--I'm sorry.
>> What's a wait-list?
>> GOLDIN: A wait-list control is people were randomized either to waiting several months
before they started the mindfulness class versus people who got it right away.
So this is mixed--these are people with mixed anxiety depression and what you see is that
there's, from pre to post mindfulness-training, a reduction.
But more importantly, the amount of meditation that people practiced during the two and a
half months, predicted significantly, 50% reduction in rumination.
>> [INDISTINCT] >> GOLDIN: Yes.
Good point.
So this is actually--people with the mindfulness--for some reason, the people who were assigned
to the mindfulness group, reported greater rumination at baseline.
So, there way to--there are statistical ways of dealing with that, but that's also why
we need multiple studies than you average over them and then those things like that
hopefully drop out.
Those same question, yeah, yeah.
So they were more elevated than negative rumination, the sample at baseline.
Giving his talk.
So I'm sure that everyone here at Google, almost everyone, probably has to do--to be
evaluated on performance.
The most fearful, feared, social performance activity in the world is for public speaking.
Fortunately I don't have that, but a lot of people do.
And not only is it fearful, maybe in the moment, when somebody has to present in front of peers
or managers or bosses or CEOs, but people will ruminate, it was what were talking over
lunch, some people will actually--in my [INDISTINCT] with me for two weeks, before talk has to
be given.
Negative, you know, anxiety, diarrhea, fear, sleeplessness.
So this is something that a lot of people experience.
So this is the most fearful social performance thing, but there are many, many others as
well.
So what is social anxiety?
Well, it has a huge lifetime prevalence in North America.
About 12% of adults in North America will meet criteria for social phobia or social
anxiety disorder.
It's the third most common psychiatric condition after major depression and alcohol substance
abuse.
Third most common.
It has a very early age of onset.
Eighty percent of cases of social anxiety begin before the age of 18.
In fact it's the model time of onset is really about age 10, 11, 12.
And it's often undiagnosed, untreated, or even if somebody shows up treatment for anxiety,
the clinicians usually don't ask about social anxiety.
So it's usually occurs early and it usually precedes the subsequent development of major
depression, substance abuse, and other anxiety disorders.
The other very important thing about social anxiety in its early age of onset is that,
it's associated with the highest high school drop-out rate of all of the anxiety disorders:
OCD, panic, generalized anxiety, agoraphobia, etc, etc.
So this is really why people are interested in going younger, younger, younger.
So, what is social anxiety from the first person experience?
So we--for all of our participants, we ask them to identify four painful social situations.
This client offered the following: 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 and to admit to my manager what I had done and how I had failed.
So we actually use these scripts, autobiographical scripts, as stimuli in our brain imaging studies,
induction of a specific painful social memory.
This is about as real as it gets.
Then we also ask people with respect to that situation, your own situation, what are the
automatic negative self-beliefs that arise?
This client offered: What's wrong with me?
Why do I get so nervous?
I'm going to get fired for not being able to do this.
The President must think that I'm an idiot and wonder why they hired me if I can't even
speak to a few people.
If I get up there, I'm going to blush and either throw up or pass out.
So mental tripping, cognitive distortions, fear of physiological arousal that I'm not
gonna be able to control.
So, one model of social anxiety, a cognitive model says the following: When a person has
social anxiety, is in a social situation, it triggers a distorted view of the self,
the social self "I'm not good enough as I am.
I'm going to screw up."
This means the situation is a place we're evaluated as "This is a dangerous place for
me.
This is threatening to myself."
And then there's a very rapid attentional shift to self-focused attention.
So much so that in studies were you have other people to say, "Hey, no you're doing fine.
You're doing fine."
The person is so internally aware, internally driven; they don't process external information
which, of course, reinforces the disorder.
And this leads to safety behaviors, not showing up to work, not making eye contact, not speaking
up, or being assertive when one needs to be, for example.
Not going to parties, bodily or somatic and concerns and problems, diarrhea, etcetera,
cognitive problems, negative thoughts, etc.
Here, I'm going to be focusing on attention as one way to probe the brain in people with
social anxiety and how mindfulness might modify the neural basis of attention.
So the big question here is integration.
Can we take incredible, beautiful, elegant technology the West has to offer which is
to basically go under the skull noninvasively and image the brain while it's doing what
it does?
And ancient wisdom traditions of methods that has been used for 3000 years of how to work
with the mind; ways to actually identify and begin to modulate mental patterns.
Can we integrate this?
A full description of a phenomena would really entail all of these levels of granularity
in my library looking at genetic predispositions to people who have different anxiety disorders,
to who will benefit from cognitive therapy, from mindfulness, from medications, how this
influences molecules, neurons, neural circuits, and in cognition, emotion behavior.
This will be a full explanation.
Here, today I'm just focusing on brain and cognition emotion.
So we use the MRI, Magnetic Resonance Imaging, which essentially is a huge magnet.
Beautiful machine.
Here's a picture, this one is the Dalai Lama, Richard Davidson, a researcher from Madison
showing His Holiness, the Dalia Lama, how this works.
And I'm going to give you a one slide primer on what is the dependent variable in FMRI,
Funtional Magnetic Resonance Imaging.
You're lying in the scanner on your back, like the woman you saw a moment ago, and then
what I do is I present you with a negative belief.
"People think I'm socially incompetent," you read that.
This triggers firing in specifics populations of neurons, having to do with language processing,
self reflection that activate neural circuits, brain systems, not just specific areas but
circuitry.
That then says, "Hey, the neurons are firing, please send more oxygenated hemoglobin, more
cerebral blood volume, cerebral blood flow to the areas where neurons are firing.
Bring more oxygen; bring more glucose because the neurons are consuming energy."
And then we, through a lot of signal processing and statistical modeling, try to infer what
are the parts of the brain that are active when a person is spinning on a negative self
believe?
So it's a whole series of processes--steps, but we can do this.
What are the possible brain bases of the psychological mechanisms that mindfulness may attach?
Well, attention, emotion regulation, self view.
Wonderful work by Merry Philips, Helen Mayburg, and lots of neuroscientists are beginning
to delineate where does emotional reactivity occur in the brain and emotion regulation?
So in the context of a social situation that's feared, this could actually activate very
quickly, fear, arousal, anxiety.
So we know that roughly, this is very condensed, but roughly there's the limbic and paralimbic
system in which there's a whole set of brain regions that detect what's personally salient
and even generate emotional reactivity.
This sends a signal, bottom-up signal, "This is threatening to me.
This is dangerous to me."
And it actually recruits activity in regulatory systems, many of which and instantiated in
the prefrontal cortex parietal that says "Please select some strategies and engage in top-down
regulation to either increase or decrease the current emotional state."
So we are literally doing this consciously, non-consciously in our brain all the time.
And these regulatory practices often are mediated by the way that we view our self and our skillfulness
or lack of skillfulness in language: How we think, how we interpret, how we view our self.
So here's just one task, for example, that we use.
We ask people--we present people with their own painful autobiographical social situations,
like the one I read earlier, then we have to present one negative belief at a time and
have people spin on their own negative belief about themselves in that painful situation.
Then we ask them to provide a rating and then we train them to implement some kind of emotion
regulation strategy.
Attention focusing, here, that was operationalized as "When a cue comes on above your negative
belief, please shift your attention to the physical sensation at the tip of the nose
of the breath moving in and moving out."
Physical subtle sensation, shifting attention.
We also have an attention distraction condition as a control where we ask people a pair of
three digit number and say count backwards by one from a three digit number, 168,167
and so forth.
Attention distraction.
And then thirdly, cognitive reappraisal.
Think in a way to reinterpret the meaning of the belief, to make it less toxic for yourself.
Three different strategies.
There are many more than this.
We only look at these three.
So, cutting to the chase, we found that post mindfulness training, post-MBSR, we found
that all three forms of emotion regulation, the ability to volitionally work with your
psychology brain to down regulate negative emotional reactivity.
We found that the red bars are ratings of--subjective ratings in the scanner of negative emotion
to the negative beliefs.
The blue bars are that same rating after doing self-talk or cognitive regulation, after doing
attentional focus, and after doing distraction.
All three methods were more efficacious after doing this two-month training in mindfulness
meditation.
Greater skill in being able to identify emotions and to skillfully regulate them as needed.
Just to go into a little more detail, attention is a very limited resource.
We all know that.
It's also that attention itself is not a unitary thing, but actually has many components.
So, three components here.
Michael Posner is the superstar person in the field of attention.
He's done incredible work on all levels, looking at from genetics to training kids, in attention
abilities.
And here, they--he and his former student who's a professor at [INDISTINCT], they've
developed a wonderful computer task that assesses three components; there are many more, but
only three components of attention.
Alerting, meaning the ability to sustain your vigilance on an object, to focus on an object.
So your coding, can you keep your mind right on the object?
You're meditating on the breath; can I keep my mind right on the breath?
Reorienting, when the mind becomes distracted, can I switch or shift my attention back to
the object of meditation, back to the object of the work that I'm doing?
Third is Executive Control, selectively attending to I want to focus on, actively inhibiting
things that are task-irrelevant.
This is considered executive functioning, or cognitive control, or top-down control
of attention.
These three, from alerting, to reorienting, to executive, literally develop in the brain
over the first two decades of life progressively.
Such that kids really develop executive--begin to develop executive control in their teens.
So there's literally a developmental trajectory of these abilities in the mind brain.
These three components are instantiated in the brain in a distributed network of brain
regions which is really wonderful because that means we can probe the effective attention
training on the neural substrates of these components of attention.
So, do you find enhanced or decreased activity when people are more distracted, when they're
more focused, when they've trained the muscle of attention, or different ages, or on or
off coffee, for example.
Cutting to the chase here, the regions that are in these colorful circles are regions
that we found to be the parts of the brain that were more active, that make up parts
of this attention network from pre to post mindfulness training, in this case, 15 adults
with social anxiety.
So, meaning that, people who, these sociophobics, who engaged in the mindfulness mediation training,
when challenged to regulate their attention, from pre to post training, they showed increased
neural activity as well as behavioral indices of the ability to regulate their attention.
Fifteen is very small, so this was the basis for getting an NIH grant and now we're doing
this with 60 people.
Also randomizing people to mindfulness based stress reduction and exercise wellness program
based stress reduction, because exercise has been shown in some cases for people with certain
kinds of anxiety disorders, to be just as efficacious as some kinds of therapy.
So it becomes important to delineate group effect, exercise versus not exercise, attention
training versus physical motivational training, to really delineate what are the--how do brain
systems change.
What--how are different clinical interventions better or worse with different kinds of anxiety
disorders.
So this was very promising that we literally saw neural evidence along with converging
behavioral evidence of attention training.
To look at the amygdala, in this case, the right dorsal medulla, this is a brain region
that it's very popular because when people are experiencing emotion, this is an area
that becomes very active.
So, when spinning on the negative self-beliefs "I'm not good enough.
People don't like me," we found very strong amygdala activity.
And I want to show you what happens during these conditions: Spinning on my own negative
belief, shifting my attention to the breath, healthy controls, some reactivity, some down
regulation.
Sociophobics at baseline: Delayed but then a rapid increase and then subsequent decrease
in amygdala response during spinning on negative beliefs.
So it takes some time to bellow up spinning on the belief and amygdale, the brain, this
part of the brain, is literally reacting to this negative beliefs.
Now, this is Pre and Post.
The black is Pre, the same people, Pre mindfulness straining.
Orange is post.
And there are few things that I want to point out.
First, here, there's an initial burst in the people after the mindfulness training in this
amygdaly reactivity when spinning on beliefs.
One of the things that happen when you slow down and when you become more aware of body,
thoughts, emotions, is that you become more aware.
That's not always pleasant.
But that's not--the goal is not to remove what's unpleasant.
It's to be more aware.
So, one way to interpret this initial burst, is that people, in this case the sociophobics,
where actually more aware of their emotional reactivity when they were confronted with
their own negative beliefs, greater emotional awareness.
But notice that then it quickly dropped.
Notice that this occurred before the instruction to shift their attention to the breath, what
was initially a cued effortful process to shift attention to the breath.
After two and a half months, these people shift to the left and start to implement the
attention regulation automatically, perhaps with awareness, perhaps not.
Meaning, that what was an effortful practice becomes automatized.
>> Whatever this means, being valued the [INDISTINCT] population?
>> GOLDIN: Yeah.
This is--these are across the fit--in this case, the fifteen adults with social phobia
and themselves two and a half months later in the same exact task.
>> Do you have any sense, sorry, in [INDISTINCT]...
>> GOLDIN: No, go ahead.
>> ...like of a, like error bars, so we can tell...
>> GOLDIN: Yeah.
>> ...I can't tell whether, you know, whether this squiggle is just noise or whether that's
actually meaningful.
>> GOLDIN: Yeah.
That's a good question.
So, the fMRI signal--there are many ways to do signal processing and fMRI brain reactive--brain
neuro response tends to be quite noisy.
So we do a lot of stuff and the only place where it was significant, the only place where
you see a significant drop--significances here in the sociophobics compared to themselves
baseline, post MBSR, where you see this reduction.
That's the only where it's significant.
Of course it's only fifteen subject which is why this was pilot data for 60 where your
going to have more power because that's--in psychology, fifteen is a small sample size.
>> It may not be [INDISTINCT] but what do you--how do you interpret the gap at the end
of the chart were the trend reverses?
>> GOLDIN: Yeah.
Its miles significantly different and actually, you know, I don't have an interpretation for
the end of this.
In fact, these are each 12 seconds so realistically, another way to do this, and we're trying it
out, is to makes this two minutes long.
Because when you think about reactivity to something, you're in the hallways, you say
"hello" to Suzie and Suzie doesn't look at you, or Suzie--Suzie's absorbed to something
and is not really attending to you, the reactivity--there's an immediate reactivity, there might be a
quelling, and then there's a continuing burst as we spin or cascade on "What's up with Suzie?"
Like, "Why isn't she paying attention?"
"Why is she dishing me?"
So, real samples would be much longer than just 12 and 12 seconds.
So we're actually exploring that now, doing two minute--several two minute samples which
I think is probably more ecologically valid but we have to start somewhere.
Also self view I just wanted to give just a little bit here because this is something
that's really exciting which until recently no neuroscientist would ever touch.
Now there's a burst of interest in "Can we not find the self?"
That's not the enterprise.
Because there is no--there is no central brain region of self, but there are different ways
of manipulating how a person views themselves and you can see that in the brain.
So here, here's one version of the self Analytic Narrative View of myself.
This is past-future oriented: How is Philippe yesterday?
How is Philippe going to be tomorrow?
Its conceptual, it's a fixed concept and it's associated with ruminating on the self.
It's a very conceptual linguistic-based view of self.
In contrast, there's another version of this way of relating to the self which is really
more experiential.
Present-moment focused which is why this is interesting for mindfulness, continuously
changing experience of the self.
Not a fixed concept.
A reduced over generalize memory which actually mean is been related to reduction and depression
and anxiety.
So, in terms of creativity, given that this is a very creative place, reading some--in
preparation, I was reading some stuff on creativity, the extent to which a person has a fixed view
of themselves and their abilities, they perform at that level.
They extend to which a person has a more fluid sense of self, less caught up in fixed conceptual
notion.
That person, literally in experimental studies, can make associations that are more long,
more interesting.
They can bring things together that normally are not very closely associated; they have
less abstraction in thinking more creatively.
If you have self, I think is at the basis of that kind of the intellectual creativity
and neuroscience are just beginning.
It's actually hard to publish neuroscience of self studies, but there's an interest right
now.
So in terms of this two, more analytic, more experiential, more embodied sense of self,
and what we find is there's--across many, many self studies, you see there's this set
of three brain regions that come up all the time.
These are midline structures: Medial prefrontal cortex, dorslal medial prefrontal cortex and
posterior singulet.
These three show up all the time.
In this particular study, we found out in controls and also sociophobic which is very
promising.
So, this is a very robust when you're doing self-focused attention.
Cutting to the chase, what we found here is, in the sociophobic, post mindfulness training,
we found significant reduction in neural react--neural response from pre to post in brain regions
having to do with linguistic processing, thinking to your self--about yourself.
Cognitive regulation here, more this--reduction in metacognitive awareness, parts of the brain
and how to maintain a concept of self are reduced.
And medial prefrontal, place where self-focused attention occurs--tends to occur, also went
down.
Reduction in thinking, maintaining a concept of self and self-focused attention dropped
in the people who did the mindfulness class.
So they had a less of this conceptual narrative fixed concept, and had more of an embodied
self.
And this is--the hot colors here indicating greater attention, actually.
So in summary, I hope that I've shown you, is that for people who completed the mindfulness
class, in the context of a threat stimulus, personally, it is, sort of syncratic negative
self-beliefs, reduction in emotional reactivity, and increase in the ability to apply different
regulations strategies, be they cognitive or attention, and decreases in conceptual
sense of self and use of language in the context of ones own negative self-beliefs.
Meditation is associated with changes in the neural bases of attention regulation, shift
from conceptual experiential self and, I didn't show it here, but we're now looking at neural
synchrony across brain regions, are they more connected, integrated in temporal analysis
in people who have done more and more meditation practice.
Thank you for your attention.
So there are many other studies that we're doing, etcetera.
But I'm more interested in what you think, and questions you have, maybe things from
your own experience or what are some of the implications?
Where would you push, pull, drive is going to work?
Do you have a microphone?
>> Here.
>> GOLDIN: For people who are remote somewhere, sir.
>> Yeah, one of your slides cited as an aspect of the more conceptual notion of self over
generalized memory, could you say a little more about that?
>> GOLDIN: Yeah.
In people with, specifically with people with depression, there tends to be what's called
over generalized memory.
So when you ask people who are in a current repressive state to think back about a situation,
they tend to color their memory of past situation as "Oh, I was always sad.
Things always suck."
They actually lose--women in current depression, may lose memory for details and they over
generalize into, kind of swats of memory and inferences, as opposed to remembering details
for specific events.
And that's been shown prospectively.
You take me when I'm fine, current happy state, depressed state, "Philippe what happened three
weeks ago, six weeks ago, nine weeks ago," and you've recorded those.
I over generalize and I lose specificity over generalized memory which is problematic when
you run to a person and say "Yeah, you were sad," or "this occurred but you," you know,
they'll hear the details of how you responded and your were effective, people tend to forget
that.
>> I'm curious, how much of this works cross culturally?
Like for example, in Japan people get up and sing in front of each other where, that must
be very common, right?
>> GOLDIN: Yes.
Thank you so much.
I did not ask him to ask that.
Social anxiety in particular, manifests differently.
Okay.
So here we go, west--no but we are very mixed culture right here.
But in the United States, generally it's the cowboy culture: rough, tough, strong, individualistic.
People with social anxiety have a very poor self-esteem and they're very worried that--about
negative evaluations by others of the self.
Japan, there's another form of social anxiety where the fear is not about me, but other
people, you know, other people having a negative evaluation of me.
The fear is that "I'm going to do something in public that will embarrass you."
And is a very clear, specific form of social anxiety that is "I'm terrified that I'm going
to do something to embarrass you."
That is really culturally influenced.
The next question is, so you take people who are from, say, mainland China.
They moved here, then they had children.
First generation, they have children, second generation, when do you begin to see shifts
in patterns of psychopathology or shifts in--sub forms of social anxiety?
From landing here, first generation, second generation, cultural influence infiltrates
the view of self, language.
For example, in Tibetan language, there's not a word for self--low self esteem.
There is no such word, so much to that at a meeting with His Holiness, the Dalai Lama;
people were like, "Yeah, one of the many things we have here is low self-esteem.
We do everything to buttress up and make everyone think that we're doing fine, and we don't
need your help, and I don't need your help," but in fact that's--we know that's not the
case, whereas, in Tibetan language, there is no such word.
Also in Tibetan language, there is no word for emotion.
Destructive, harmful states of mind, no word for emotion which--think about Greek, you
know, Greek, ancient Greek culture, ancient Indian culture.
There is no word for emotion in Tibetan language.
>> Just a minor...
>> GOLDIN: Oh, mic, mic.
In case somebody wants to hear it.
>> Just a minor comment.
Not big.
I remember I had a lecture a number of years ago, the speaker who is a historian from Yale
said, "There is no word for "shallow" in French even though some people might argue that the
French invented the concept."
So, the fact that the word doesn't exist doesn't necessarily mean that the concept doesn't
exist...
>> GOLDIN: True. >> ...or the problem, even without the concept.
>> GOLDIN: True.
But there's recent study that was done in UCLA where they, in healthy controls, they
induced certain emotion, emotional states and then what they did is they had people
label the emotion.
The act of labeling ones emotion which is a cognitive method, right?
Already distanced oneself from the emotion state, "Oh, I'm angry."
There's an awareness and there's--just labeling distance from itself.
So that is a form of emotion regulation, just using language in that way.
So, in one way, I would go the opposite, can we actually become more skillful in identifying
subtle, subtle, subtle, emotional states?
Be it viscerally [INDISTINCT] cognitively, and then apply a more refined vocabulary to
identify those and label them.
So--but it's true, with--even when we don't have a label, people still experience things,
but then they just don't have--there's not a consensus on a word that I would use to
communicate that.
>> How long after the MBSR training, did you measure your subjects?
>> GOLDIN: How long...
? >> After the MBSR training.
>> GOLDIN: About a week or two, after completing the mindfulness program.
And--so that would be kind of the immediate effects of having just competed.
What we're doing now, is we're following people for at least a year after completing therapy.
Because this was a good point, learning often occurs, consolidates overtime, and there's
even evidence that two, three, four months later, people who actually get it, even after
completing a course or--even psychotherapy, yeah?
>> You presented the limbic system as a reactive system, but isn't it an also an active system
that seeds negative thoughts and emotions?
>> GOLDIN: Say it again because...
>> Isn't it also an active system that seeds things in the cognitive part of the brain?
>> GOLDIN: Oh, not seeds no, yeah.
So the limbic--the limbic system is a distributed set of nodes which has been associated with
emotional states and specifically, emotion detection.
So like you watch a disgusting film clip, there's this limbic system, there are parts
of it, like the anterior insula, amygdala that will--when something salient comes on,
it would be more active.
So emotion detection, but also when you--when you do a mood induction, emotion generation.
Seeing will not--doesn't occur in the limbic, although...
>> I said seeding.
Not seeing.
>> GOLDIN: Seeding?
>> Seeding emotions as well as [INDISTINCT].
>> GOLDIN: Oh, seeding, as in generating.
>> Genrating.
>> GOLDIN: Yes.
So, then also there's generation of emotion.
Not exactly the same set, there's a sub-set of regions like subgenual, anterior cingulate,
and amygdala are associated with generating emotion.
When you actually ask people to--there's a study when you'd ask healthy people to generate
sad mood, or people with current major depression to generate, to enhance the sad mood, there's
some reliable areas that are associated with increasing.
And those have actually become targets of direct brain stimulation studies right now,
with surgery, in fact.
A little controversial but, yeah.
>> The functions that you mentioned are learned in childhood, like the executive function
and...
>> GOLDIN: Uh-huh. >> ...are some of those better--are there
some that adults can learn better than others?
Are there some that the brain development--there's two point where it's harder to, to change
in adult stage as suppose to others?
>> GOLDIN: Yeah.
As a general principle, the older--the more that we're alive, the longer that we're alive,
the--in general, there's less plasticity.
So much so you can take a three year old and take out the entire left hemisphere, and all
the functions that were supposedly instantiated in left hemisphere, transfer.
There's a beautiful, amazing, I mean, we human animals are amazing in that functionality
can shift across brain matter.
So there even examples of people who are born with only one hemisphere, and only later when
they were teens did they ever get an MRI that showed "Oh my gosh!
Hemisphere is gone," and they seem almost 100% normal.
So it's a beautiful plasticity.
But as we get older, we become more rigid.
As we become older, cortex becomes thinner, one study that--a cross sectional study that
was done by Sarah Lazar showed that cross sectional, where it's not prospective, cross
sectional, they found that people--longer--people who reported being meditators for more years
had less cortical thinning compared to aged matched people who didn't do any meditation.
So that was really exciting and interesting but its cross sectional, co-relational which
is, you always have to take that with a grain of salt.
So having said that, there's all sorts--there's a huge interest in neuroplasticity right now,
but it doesn't seem to be present in the entire brain, but only portions of it.
So there are limits that people have to train their attention that can--might be constrained
by genetic, might be constrained by life experience, but also are constrained by not having [INDISTINCT].
So, I wouldn't say you can take somebody who has early stage Alzheimer's and be able to
train that away.
Not even close.
But we can harness our attention and if you'll sit with somebody who's done a lot, a lot,
a lot of practice, you can feel it.
It's--it's palpable.
And you can measure it which is important.
Okay.
Thank you.