David Vago || Mind the Mindfulness Hype

human possibility. Thanks for listening and enjoy the podcast. Hey everyone, before we start this episode today, I just wanted to make a quick announcement that this is going to be the last episode of the season. I've been doing this podcast for the past five years and haven't had any breaks, so I'm really looking forward to actually taking a step back for a couple of months and think about how it can make this podcast even better and more eye

opening for you all. So stay tuned for next season, and until then I will be releasing reruns, so enjoy the reruns until we come back and season better than ever. Today, it's a delight to have David Vogo on the podcast. Doctor Vago is Research director of the Ocher Center for Integrative Medicine at Vanderbilt University Medical Center. He also maintains an appointment as a research associate in the Functional Neuroimaging

Laboratory at Harvard Medical School. David aims to clarify adaptive mind brain body interactions and their therapeutic relevance and healthcare settings. In this context, David has been specifically focusing on the study of mindfulness based interventions and clinical settings, and the basic cognitive and neuroscientific mechanisms by which mindfulness based practice function. David, so great to chat with you today. Really glad to

hear Scott. Really a wonderful to the party community. Well, you know, the Psychologic podcast has represented the topic of mindfulness before and in other ways. We've had Sharon Salzburg on the podcast. We've had our and Sofer on the podcast talking about a nonviolent approach to peace, to our world betterman, and he draws a lot on mindfulness, you know.

So there's just a couple of examples, but I'm really excited to dive deep into the latest science of this field because there's a lot of claims and it's also a very popular topic if you go to a bookstore. I mean, I feel like it's a really big part of the bookstores. So i'd like to just talk to you a lot about this, And let me first start by asking what is contemplative science? Because is that like did you coin that? Is that like a new way

of just repackaging mindfulness? Go, yeah, so that's a really good question. In fact, I'd have to unpack that a bit and back up a bit, probably all the way to the Old Testament to answer that question, and then you know, to fill that in all details. I'll end up by saying the take home answer to your question,

where did contemplative science come from? It was really just a dialogue of scientists and scholars sitting together in probably two thousand and oh i would say, probably seven part of the Mind and Life Institute, which is a non for profit organization in which the Dilama and the fourteenth dia Lama is the honorary chairman, and it was started by a neuroscientist and a businessman from Harvard really with

the goal of fostering dialogue on the mind. And so being part of that organization at one point being their research director, we were talking about, you know, how to brand essentially this whole field and what would it be called if we're going to develop a curriculum, which we decided not to, but we did throw around the idea of this word contemplative science as a way to capture

the essence of studying meditative practices our wisdom based traditions. Now, if we go back to the Old Testament, so I'm going to just go back in time here we have to think about the word meditation and contemplation and their relationship. So haga or maleete, meditacio, these are all different words from Greek or Latin that were in the Old Testament and that was associated with not only thought, reflections, study,

but also contemplation. So contemplation really is a word that you see often used along with meditation across all wisdom based traditions and religions, and in the classical period between the fifth and eighth century and the Common Era, it was referred to both meditation and contemplation referred to as a general technique of focusing attention and sustained fashion with the aim of deepening states and concentration, tranquility, and insight.

From the Christian theological tradition that insight was with the nature of God, and in the Greco Roman philosophical traditions, insight was obtained to reveal the nature of mine, if you go back to that classical period. So people like Aristole, for example, recognize the practice of contemplation as the highest, most virtuous aspect of human life associated with the pursuit

of wisdom. And so there are many styles of meditation, but in essence, meditation and contemplation together refer to any practice that involves self regulation of attention. Can be used for spiritual purposes like the Christian theological tradition that did, or it can be used for philosophical understanding of the

mind from more of the reco Roman philosophical tradition. So contemplative science or contemplative neuroscience really refers to the study of the underlying neural biology and psychology and the phenomenology of that contemplative experience. Yes, thank you for that explanation. That makes a lot of sense. And trying to think of the word contemplative, it connotes to me something that's very conscious, a consciousness like enhance consciousness in some way,

or or awareness or even like deliberate conscious thought. Isn't it important to like tap into our intuition as well in our like emotional experience, even in a spontaneous way, even if it's like not deliberately contemplated. Absolutely, So to broaden the word contemplation a little bit, please do I could maybe add another concept well. Meditation also was used from the Indo Tibetan traditions. Meditation is a word that became the translation for the Sanskrit and Tibetan words dahayana

or bavana. So those are are gone, which is the Tibetan equivalent. These are from sixth century BCE, So now we're talking a thousand years before it was used in the classical period. Right, So we said there's a lot of use of the word meditation in fift to eighth century CE, but from the Indo Tibetan traditions, meditation specifically from the context of systematic forms of mental training with the goal of achieving alignment. That those words really refer

to developing familiarity with one's own mind. Now, if we get out of our sort of immediate reactions to what mind is and think a little bit more broadly than mind could encompass everything from what's happening as a result of brain activity and body activity and in relation to others and the world around us. Mind is much more broad broadly conceptualized. And therefore, if you want to include intuition into the insight that you achieve, like what is

it that I'm intuiting? That would be appropriate to put under the umbrella of contemplative practice too. Not only are you becoming aware of what's happening in your immediate environment externally, but you become much more aware also of what's happening internally. Not only you know in your body you know just for example, where your pains are, where your emotions sort of manifest, but also that intuitive feelings that you get maybe from your gut. So that is part of the

umbrella of contemplative practice. The question is is there science to show that your awareness of intuitions is any better by sitting on a meditation cushion and closing your eyes. We don't know that answer, but we don't. Do you have any evidence at all one way or the other? Or were you about fifty to fifty on this one? Well, for intuition, the problem with intuition is that it comes

from somewhere that we don't know where. We often attribute it to gut, but similar to how we feel love, you know, love sometimes is often associated with a heart and it's not like we have a measure for love or how much love you expressed by looking at you know,

heart rate or heart activity dynamics. Similarly, it's hard to understand intuition if we were to say, focus our instruments on the abdomen area and say, okay, let's see what kind of activity we see as you think about whether or not a ball is going to hit a target. Sort of intuition about that or that could be just a simple experiment, but even more complex would be just your your general than intuitions of somebody who may be a bad person or a good person that you want

to be with. I will say one thing that we're doing in our laboratory to get at some of these things that are sort of ephemeral or just difficult to measure, really is we want to understand human connection. Because in essence, when I talk about what the goal of meditation is, I often also try to get people out of their everyday sort of thoughts about meditation that it's not just about sitting with your eyes closed on the top of

the mountain and achieving bliss. It's more about establishing human connection from at least the traditions that most of my research is rooted in, so from the Tibetan Buddhist traditions, the aim of the practice really is to dissolve the boundaries between self and other, not to just decrease stress or improve our attention. Those are sort of side effects.

So when we talk about doing these types of practices, we also talk about how you can increase social connection or increase empathy, and those are also very difficult constructs, similar to intuition. And one of the things that we're doing is we're putting people into multiple people in a having to meditate with each other. They could be people that know each other well in which you resonate with, or people who are strangers so you may not know

if you resonate with them or not. And actually look at the intrack cortical dynamics between the brains and say, is there a synchrony between the brains suggesting that you do resonate with this person? And if not, by practicing say mindfulness or compassion based practices, can you enhance that connection, that social connectivity, that human connection, and dissolve some of

those boundaries that we create between self and other. So These are novel ways of getting at some of the abstract or complex phenomenological experiences that people have through contemplative practice. But we're still in the early days for this type of research. There's really a lot of research to be done in this area. Well, David, you know when I talk to you, I get a night and day versus talking to like a pop writer who wrote a book

on mindfulness. I mean, like, if I talk to anyone you know who wrote one of these best selling books, you know, a mindfulness, they sound like a completely different type of human being than what's the words that are coming out of your mouth. You're basically saying like you don't even know if the science suggests that being mindful or meditating will increase your connection to other humans. Like

you're like, the jury's out on that. That's right, That's incredible. Yeah, Well, because people talk about it in terms of the Buddha dharma, you know, they talk about it from from a Buddhist point of view of what the Buddhist spiritual path said. So you know, when when a Buddhist teacher or contemporary mindfulness teacher talks about the benefits, they're talking about it from their own experiences or from how the dharma explains it.

So the dharma are really the rules in which someone it's the guidelines by which you should practice training your mind and relating to others to achieve enlightenment. And the drama is a good instructive path. It provides what we call the preliminary practices, so you can achieve enlightenment. But from a contemporary point of view and from a Western science point of view, we don't have a lot of data on these practices. So I'll just give you a sense of where we are. Yeah, what do we know

after like twenty five years of mindfulness research. Well, that's a good point, you said, twenty five years, you know, think about you know, cardiovascar disease is a construct that we've known about for at least twice that or at least fifty years where we've been doing ongoing research. And the number of studies that have come out on cardiovaster disease is almost one hundred oh greater than one hundred

and twenty thousand publications. For mindfulness, there's only been nine that was in publications, and that's either mindless or meditation. It's less if you just use mindfulness and all of them except for nine happened after the year two thousands, So it really has been less than twenty years of research. And that should give you a sense of where we are. We're really at early days. So what do we know. I can give you some summary for you and your

listeners about what we know. What does it mean when we sit with our eyes closed on a cushion? What does it do for us? What does it do for the people around us? And what are the mechanisms? Does that to be a cushion? I like to lay on a bed of nails? Ah, I'm serious, it's a you know, a chiropatric Have you heard of those matts? Chiropractric mats. They are painful in the beginning, but immediately then terms of like a state of transcendence if you stick with

it eventually, Yeah, it's cool. Yeah, yeah, I would imagine. So most of the data I can go straight to pain for example. Yeah, and so go to research specifically on pain. You know, again, we're this is a great area because most people are interested in how mindfuls and meditation can benefit pain. We have you know, over close to one hundred and twenty million of the US population has chronic pain, and it costs over six hundred billion

dollars in medical expenses and work productivity loss. So there is a challenge. There is an epidemic not only in chronic pain, but in opiate use. So there's good reason to believe or good reason to search for non pharmacological alternatives that can benefit people in chronic pain. What about pharmological that are healthy, like CBD oil. Well, so we know nothing about CBD. We know even less about CBD

than we do. You know less about CD CBD. There's so many, so many variables that we just don't know right now. Everything we know about CBD is anecdotal. So if you go, if you see so there's the very big differences between dosages. So if you get recreational CBD, it's typically going to be such a small dose that you probably even if there was an effect physiologically, you probably won't feel it except for maybe some of the placebo.

At the medicinal level. There are one hundred milligram doses of CBD, which often has been shown to have a more of a physiological effect, but the data has not been adequately collected. There has there're just not enough data there's proportions of some of the cannabinoid receptors are actually activated more than others. So you'll see often a ratio between THHD and CBD. And we don't know yet whether one to one or three to one or zero one.

Whatever the ratio is from thhc to CBD is going to have certain effects on anxiety or pain, for example. But mindfulness, you know, has been shown at least if you have seen some of the pictures, for example, of these monks who can you know well some of that. You've heard of these stories where yogis can stick these probes through their skin, through their mouth, through their skin

without showing any pain. There was a great example in nineteen sixty three, Ti Kwang Duk of Vietnamese Buddhist monk from the pure Land traditions, sat in the middle of a circle in a I think it was South Vietnam, who was protesting the corrupt government by President Nigo Diingiem. He just sat there. He poured a five gallon can of gasoline over his head and self immolation. He sat there while and meditated while he burned. And there's been

a lot of examples of self emolation since then. This is the question that comes up naturally is how can this human being sit on fire and show no emotion expression like he's not experiencing the pain, and we go we can go straight to the Buddha dharma and the all the different sutas the descriptions for how this may happen.

And there's one called the Vedana Samasuta, which is really about the emotional and the sensory experience, and they have there's a salad Salatata otherwise known as the dark, and they say, when an instructed run of the mill person's touched by a painful, bodily feeling like fire, he worries, grieves, laments, weeps, and it's distraw It's as if the men were pierced by two darts, a physical dark and a mental dark.

And what seems to be happening is in the case of the well taught disciple, when he's touched by a painful feeling, he will not be distraught. It's the kind of feeling he experiences, a bodily one, but not a mental one. If he's pierced by that first dart, but not the second dark. So there's an ability to distance

yourself from your own experience. So not only are your thoughts and emotions just now mental events, they're no longer facts about you or the world, but the experiences that you're having in your body can also be You can also almost have a dissociative experience where those sensory experiences are no longer painful, but just again sensory experiences, so you actually see people. That's in a very advanced monastic

how about you or me? Now, there's been data now specifically to show and this is where a lot of advancement has been made for mindfulness for pain, is to show that even four twenty minute sessions of just focusing on mindfully focusing on your breath can help you improve your thresholds for experiencing pain and also decrease the unpleasantness in which you experience pain. So both intensity of the pain and the unpleasantness will decrease, But the mechanism seems

to be how you perceive the pain changes. It's no longer something that you may be down regulating. You're not avoiding it, but you are somehow accepting it. You're aware of it, but you have enough distance meta awareness, or just distance between that experience that you don't suffer the emotional reactivity associated with it wowsers. So that sounds good. Okay, So pain we covered pain go down the list of

what we know what's on solid ground. So solid ground pain is a pretty good because I think we have a pretty good idea that mindfulness is improving how we cope with pain. It doesn't get rid of pain, it helps how we cope with it. And just like I said, an emotional reactivity is to do with pain decreases. And just to be clear, what we know about pain is

that if you're experiencing that emotional side of pain. Often if you're experiencing pain, say because you had a traumatic car accident, you may have shoulder pain that lasts a long time or neck pain that lasts a long time.

But the reactivity that you have, the emotional reactivity and the stress associated with that pain leads to what we call centralization of your pain, meaning that a lot of the receptors in your brain stem that are gating whether or not to send a pain signal to the rest of your body is becoming hyper sensitive due to your emotion. If you have lots of emotional reactivity and unpleasantness associated with pain, that's going to lead to chronic levels of

pain and fatigue. And so what's on good footing right now in terms of the research is that across all the studies, the nine thousand studies that are out there, pain is a pretty good outcome for mindfulness. It's a good target. Now. The other two areas where there's very solid I think data suggesting that mindfulance is going to be good is for anxiety. There seems to be good data suggesting that the fear or anticipation of something negative

can be diminished through these practices. And symptoms of depression as well. So extended experiences of malaise or sadness accompanied by interference with your ongoing every day demands, so relationships or work is somehow compromised, and mindfulance seems to improve our ability to cope and keep the relapse of depressive symptoms at bay. Depression, anxiety, and pain are probably the three top clinical outcomes in which mindfulance is showing positive benefits.

But if you look at the data associated now I'm talking like global meta analyzes or systematic reviews of the literatures, that this takes all the data that we have, puts it all together looks at what standard way has mindful has been delivered and has it been controlled in a clinical trial, and compares all those clinical trials together. And now there's a lot of problem with that too, because

we're limited in the number of studies out there. I'm going to give you a sense of where the limitations are because when you do these systematic reviews, there are close to ten thousand papers, for example, associated with mindfulness, nine to ten thousand papers a thousand, give or take, yeah, nine or ten thousand, And of these studies, many of them don't meet the criteria for rigorous, for the rigor that we can make any definitive generalizations about. Uh oh,

there's a lot of shit studies out there. There's a lot of shittuf you said, oh boy. So, for example, we did a systematic review of mindfulness based interventions. There are about we looked at I think nine thousand, close to nine thousand studies, and we looked at relevant outcomes. We focused on all the different outcomes, emotion outcomes, cognitive outcomes, ner imaging outcomes, mindfulens assays meaning like just self reported

measures of mindfulness and self related processing. So how much rumination, maybe are you doing and there's only about sixteen hundred studies. When you just look at those outcomes, it was the

most common. So of those sixteen hundred studies, we were able to narrow it down to about one hundred and forty that to have some randomized control not even randomized, just some control group, meaning you take a course in which there's twelve to twenty five students who are who are learning mindless once a week for eight weeks, who are forced to not out of their own volition. Is

that right? That's what randomized means. Well, they wouldn't be forced, they'd be volunteering, but they wouldn't know they'll be volunteering to be random they wouldn't be selected the mindfulness. They would be getting either mindless or something else. Gotcha, gotcha. But you see, My point is it's not a selective sample in the sense that these are people who have like they can't wait to do mindfulness, they're so excited about it, and they signed up for a mindfulness course. Yes,

so we tried so the best studies avoid that. We

called that self selective bias. That's right. Yeah, So we try to be as rigorous as possible in our review of these studies great, and like I said, we came down to one hundred and forty studies that were well controlled, and if we now look at across the different outcomes, we only found using the most rigorous standards, we only found eight studies that looked at the mindfulness based intervention in a standard delivery format eight weeks with a qualified

teacher with the core practices which are concentration, meditation, insight meditation, body scan, and some yoga. If you have all those, it's a mindfluess based intervention, and in eight weeks you only got eight studies. So that was now there are a lot of studies out there that have modified that curriculum, and that's fine because you know, if you modify and it's still functional functions to help people, then great. So, like I said, we found that even for twenty minute

sessions can influence have an effect on pain. Turns out that those same amount of time for twenty minute sessions can influence cognition. So we wanted to include more studies that showed that mindfuls practice can improve cognition for example, but didn't use the standard delivery format just eight weeks, and so then we were able to get twenty eight studies. Of the twenty eight studies, we can then look at the number of assays that people use. Assays refers to

the task that is used to measure cognition. So it could be an attention task that focuses on reaction time, or it can be a memory task that focuses on retention of words, and so each one of those is considered another assay. So out of the twenty eight studies, we found one hundred and sixty total assays of cognition, and the majority of observations that we found, over sixty percent demonstrate what we refer to was non inferiority to the control, and that's pretty good. That means the control

may be some gold standard like cognitive behavioral therapy. And this is across all outcomes. Some of these studies, the twenty eight studies are not specifically targeting cognition. That might be a secondary outcome. They might be interested in pain and they look at pain. But you know, we're just going to throw in a cognitive measure too, just to

make sure that cognition is improving. And that is that's also not the best way to assess whether mindplus is affecting cognition, because what we want to do is you want to assess all the studies that focus on just cognition as a primary outcome, not as a secondary, and we don't have that data. We're still, like I said, there's one hundred and twenty thousand studies of cardiovascar disease and only nine for mindful US. So we just need

to do more of the research. But we do know, like I said, sixty two percent of these twenty eight studies and of all those assays are non inferior to the control and in fact, twenty percent of them outperform the control. So that's pretty good. How many percent twenty percent? Only twenty percent are better than control. Yeah, so it's not a lot. That's not a lot, dude. No, no, it's not. And you're my CBD, I get it instantly. But you keep in mind, this is against an active control.

So if there was no control condition, but the control condition is not actually mindfulness, that's right. It could be CBD, CBDE, it could be cognitive behavioral TBT. CBD is is certainly an outcome or an intervention that we want to test it against mindfulness too, because a lot of people claim that CBD is helping their anxiety, but we don't know. There's no research to show that it's any better than

CBT or mindfulness, So we don't know those answers. But I can say that although the evidence is still growing that what we do know for sure, I think, are that these practices are having a profound impact on people, and we want to know exactly how, and we just need to do the more rigorous studies to make sure that indeed there are very slight populations that are going

to benefit from these practices. There may be some practices that are better than others for certain scenarios, like we now know that in trauma patients, sitting meditation for open awareness, where you're just aware of anything that arises, is challenging, more challenging than a concentration practice, and that's because their trauma will invade their consciousness quite often when they just

freely open up and let it wander. Sure, so there's definitely increasing evidence supporting its benefits, and the question is exactly how it's going to benefit a diverse group of patient populations. Yeah, I want to circle back to this idea of the potential disadvantages of meditating, like if you have trauma and things of that, what do we know

about the science of when mindfulness goes horribly wrong? So I would say there has been a an effort to quantify the adverse effects of these practices and what the research finds, and this is done mostly by Willeby Britain at Brown and what she's found is that indeed, long term practitioners will often report having negative experiences terror, fear, dissociation, the feeling of isolating. Just these have been These sort of negative experiences have been described at length in many

of the Buddhist texts, as from the Thera Voltriction. They described it as the dark night, meaning that there are certain stages of practice that you are described to go through that are terrifying, where your self dissolves and you're just starting to learn about the nature of your mind. Yeah, and realizing that there is no permanent self. So that could be scary. There is there's no permanent self. Well, your body has always changed. Yeah, there's no permanent self.

Where is the self? Freaking out? You just said that. I didn't know that. Apparently, if you learn that you are connected to all things before you learn that you

have no self. There may be an advantage to the order in which you learn those two different experiences or different relationships to the world, And in fact that somebody who loses their sense of self but is rooted in this experience of being connected to all things may not necessarily freakap right idea that yourself is going to dissolve into pieces and float away, well, you know, that could be kind of scary. But again, this rarely happens in

contemporary secular medical settings, very rare. It's now being quantified. Is now different ways to there's safety methodologies in place to provide resources to people who are having negative experiences, and most teachers are qualified to deal with those negative experiences, but they typically happen to people who are on advanced retreat settings. Whether it's a five day or ten day, or three month or three year retreats, it doesn't matter.

People have these varied experiences and deal with it in different ways. So you have to keep in mind that even cognitive behavioral therapy gold standard for psychotherapy, there are when you have a psychological history of trauma, sitting with those thoughts and memories of the past can be very upsetting, and so the exposure and reconsolidation of adaptive ways of thinking about these experiences are part of the therapeutic process,

and so that's accepted. So yeah, so people may experience adverse effects, but nothing that's going to leave a scar for most people. There are instances in which people do experience adverse events and have trouble reintegrating, but that is, like I said, it's more rare than common. Okay, cool, So let's talk about mindfulness and its effect on cognition. You wrote an interesting paper talking about some of the confounding factors and methodological limitations of measuring cognitive outcomes and

mindfulness based intervention research. Can you talk about some of those factors and limitations. Uh, yeah, yeah, exactly. So, first of all, this is the paper. It's in a special issue of Current Opinions and Psychology, and it's just coming out now. We've curated. I'm editing this with two other colleagues me Bernstein and Tors and Barnhoffer, And in this special issue is a great, really rich reflection on the field. Is over fifty five articles contributing, including a commentary by

John Capotsan. Richie Davidson also contributes. So it's a really good reflection of what where the field is and one of the did you read the whole thing? What did you actually read the whole thing? You read all fifty five I had to read all the things as the editor. Yeah, it was I didn't think I was going to when we started the whole It was a lot, but it was worth it because the issue is just so rich full of commentary. Its I highly suggest your readers check

it out for some opinions. But in there we do talk specifically about the systematic review that I was referring to earlier, which was looking at, you know, those sixteen hundred papers that are out there, what did we find right? And so, like I said, the limitations are, there's plenty of them. Because of the sixteen hundred studies, we only got eight that affect cognition. So there's a problem in standardization and rigor in methods out there currently to make

any sort of broad generalizations about cognition. And that's okay because we're in the beginning stages of a field. It's not like mindfluss doesn't work for cognition. It's just of all those sixteen hundred studies you know that were not included, they were basically pilot studies to show that this intervention is effective, it can help, it can work. And so now we have our work cutout for us because we say we have to identify what are the main outcomes

or cognitive outcomes that are impacted by mindfulness. And we have some inkling now that of those assays that we looked at, fifty percent of them show that mindfulness outperforms the control when they've focused on attention or a construct

called inhibition. Right, So inhibition is important because it's an executive function that allows you to override impulses that maybe otherwise automatically elicited, like eating a whole piece of chocolate cake when in your mind you said you didn't want to eat a lot of sugar, and there you are, there's a piece of chocolate in front of you and ate it all and you're like, ah, man, I didn't

mean to do that. So that inhibition or impulse control is one of the areas where you see mindfulness really having an effect, same as attention. So now we can focus on those two areas, do the very rigorous studies that are necessary and come up with more novel assays. So one of the limitations in the field and in the field of science cognitive science in general, is our limitations by the assays that we have to measure cognition.

So if you go to if you're a scientist, a cognitive scientist, and you want to study sustained attention, what do you do? You go to the internet. You look for research that's been done on sustained attention and you see what measures or assays they other people have used and have validated to essentially say, this is a good measure for attention. If you want to know if attention

is affected, use this measure. So one measure that we that seems to be effective is, for example, one that was developed by Mike Posner, who's a very big attention researcher. He developed a model in which we can study attention by breaking it down into components of alerting, so being alert orienting to an object in space, and engagement and disengagement processinges, meaning how do you engage on an object and then disengage so you can then move on to

the next object. And there's a task called a flanker task or the attention network task test tests and attention network test that uses these components alerting, orienting and monitoring, and engagement and disengagement. So these aspects of how you experience attention, and it can differentiate between those processes. Mindflas has been tested on this task a few times and the data looks like it's effective at some level. But if you don't have an attention deficit to begin with,

it's unlikely that you're going to just improve attention. If you're healthy and have normal cognition to begin with. Yeah, so what we do see, it's not that it's going to make you a super smart or super it's going to enhance your super or cognitive capacity to your your having supercapacity. We are limited in what mindfulness can really do.

But what it can do is it can prevent the degradation of your cognitive capacity and that's been shown, and it can improve your capacity if you're already at a deficit due to something like anxiety or other something else. Right, So the limitations are that we are limited by the measures of the assays used to assess cognitive functioning and

we don't have a lot of new ones. So sustained attention can be measured by this anti task, or there's maybe two or three tasks that you can really choose from off the shelf to study cognition and attention specifically. So one of the things that we're calling for in a lot of these reviews the mindful literature is to

improve the assays. We need better measures, So attention is one we're doing things like right now, for example, we're interested in how well you can sustain attention, and we can look at your brain networks of activity while you're paying attention and determine whether your brain is activating networks associated with sustained attention or whether it's dropping into a state of mind wandering and distraction, and we can quantify

how much of that you're doing. That is something very novel that we're working on, so hopefully we have some data about that soon, I hope. So there's a lot of people, even without add that have a tremendous difficulty focusing on their tasks exactly. And this is one of the areas where I think mindfuls and meditation can excel because these are people who have deficits right and cognition. So let's see if we can improve their deficits by

focusing their attention in a very systematic way. So ADHD is a great example of where we do see benefit. Depression is another area where we do see benefit as well, and we can look at these benefits through objective means.

So we can look at I focus a lot of my research on EEG and fMRI as methods for assessing objective objectively aspects of cognition or emotion, So we can actually look at how the brain's bonds to say, you know, different emotional stimuli, and you can look at even early stages of processing which happened before you even have awareness. You know, you show you know, I don't know. I

can show your picture of this mug. You see a mug in front of you, and you know before you even aware that this is a mug or you know, if it's something that you can even use for drinking out of your Your brain is responding. It's alert, it's oriented towards the object, it's engaging on the object, and it's disengaging from maybe the thoughts that you had about

the next question or whatnot. So you are are using your resources to allocate to an object and then you have to disengage from this object and move on to the next object, which maybe in this case of all you know, so how quickly you can do that is can be measured, and that's something that we're interested in doing, but there's not a lot of data on that yet.

There's some data suggesting that meditators don't allocate as many resources to each object as they arise in time and space, so that when two objects come close to each other in time, that you can pay attention to both of

them with an equal amount of resources. And in many people with anxiety or AHD, if the two objects come too quickly in time, too quickly, you may not even see the second object because you're stuck on the first one, right, So all your resources are dedicated to that, and that's one of the benefits we see in mindfulness is that your resources are allocated efficiently, that when you're paying attention in the present moment, there is less resources allocated to

any other processes. So we're just learning how to better target those processes and measure those as outcomes right now. I think that's where many of the limitations are is just being creative about the assays that we have to measure these outcomes and identifying what are the mechanisms by which these practicism are practices are actually showing benefit. Right. So I've mentioned a few stability of attention, inhibition and

control of attention, regulation of attention or emotion. Right, these are really important aspects of human cognition that we think mindfuluance can benefit. So benefit for what like creativity seems to involve, because I've studied the science of creativity and we find it's the exact opposite of what you just mentioned.

It's actually lowering your prefont to cortex gates. That is a really important points, especially because one of the take home messages you find often in the literature is that mindflus is good for decreasing mind wandering. I love mind to wandering, I love daydreaming. There, this is great. You're a good, good person to talk to about this, because indeed, mind wandering is important for a creative incubation of ideas, right, for setting goals, for just you know, reminiscing. There's a

lot of really beautiful things about mind wandering. In fact, our mind is made to wander, it's made to evaluate the world. But where it gets us into trouble is when we have ongoing task demands to do something else. And so the way that we deal with This conflict is what's referred to. Jonathan Smallwood and Jessica Anders Hannah are two researchers that focus a lot on their Yeah they're great, and they coin this theory called the context

regulation hypothesis. Essentially, what are the costs and benefit of self generated thought or mind monitoring? The costs and benefits are context dependent. So if you're doing mind wandering under conditions that demand continuous attention, like you know, you're trying to do your emails or write a paper, but you keep getting you keep distracted by your Twitter feed, that's unproductive because it's a source of error, or you're not

doing what you intend to do. If you are doing it under non demanding situations like laying your bed, sitting on a cushion at a stop light, in your car, in line at the grocery store, whatever it is, it could be beneficial because it's associated with this creativity or control,

so on and so forth. So you can what we see, and this is where I think if you look at the granularity of the of the data, you'll notice the mindfulness doesn't increase your ability to or decrease your ability to mind wander, or decrease your frequency of mind wandering, which you may actually do that, but what it's really good at doing is allowing you to flexibly switch between the mind wandering state and what's happening around you externally

or internally. Flexible attention, yeah, flexible attention, and rapid toggling between what's happening in the world what's relevant, and what's going on inside you and what's relevant, So really switching having access to all different aspects of your cognition, that ongoing cognition. So like, yeah, I agree that, I agree

that that's important, and I like that framing. But when I read some writings on this topic, like cabit Zen's book Trully Catastrophic Living or whatever it's called, something like that, fully, yeah, something like that. When I read that book, he kind of full catastrophe living, right, He kind of makes it sound the height of mindfulness is like when your default

mode network is silent. And that seems like a different narrative than the narrative you're telling me, which the one you're telling me now is like more integrative with my own research on creativity, and it makes a lot of sense. But I see another narrative of mindfulness out there, and even of like LSD like when Paulin wrote his book, he has a whole chapter on how like the height of his existence was when his default mode network was not existent anymore. And I'm like, no, that's a problem,

because i love the default mode network. Thank you, yeah, thank you. This is a very problematic narrative. You agree, it's problematic. Yes, good. In fact, I'm my pet peece so it is a pet peep of mind as well, and it makes me excited because this is the most some of the most interesting areas for you know, getting into the gri annularity of what mindfulness is doing. What is it when you sit with your eyes closed in

silence happens in your mind? And you have to then go back between the Buddhist model and the contemporary model, because the Buddhist model provides a lot of insight into not only what you're supposed to be doing, but what you may notice may change or transform as a result of practice. And what you have to keep in mind is that although John Cavit's in he says that he describes mindfulness as paying attention in the present moment, non judgmentally.

When he says non judgmenttally, he really refers to this sort of being stuck in the mind wandering evaluative self state where you are continually reflective of self processing, ruminative, so on and so forth. These are not necessarily negative, and they can be positive too, but they're more often

negatively oriented and they're tent of thoughts. So what we really want to know in the meditative mind is, like I said before, how much of the time is spent in default mode or mind monitoring state versus focused attention. And even from the Buddhist model, the evaluative aspects of cognition are emphasized in by describing a process called discernment. So you often see meditation teachers talk about a non evaluation or non judgment They say, pay attention to the

present moment, non judgmentally. But then in the same breath they'll say, now be discerning of what is happening in your body. So I'm supposed to be non judgmental or discerning? Which one is it? Because discerning implies the valuation. So this is just semantic problem and we are I think the Crossroads of John Capisen calls an inflection point for

the human species. That's how he describes it. But I see it as a moment in time where the neurosciences of mind are being informed by this whole mindfulness movement. We're learning about what it means to just have a resting mind, what does a resting mind look like? And indeed there are benefits of mind wanting for creative incubation of ideas, But then there are negative outcomes. If your thoughts are all negative about yourself and your worldview, if

there's tons of fear or anxiety, that's not good. So we have to properly contextualize it and realize that judgment and valuation is helpful for creative incubation, for a goal setting, also for determining appropriate behaviors. Right, what is the appropriate decision to make in this context? And that has to happen rapidly. So we think, at least theoretically, that mindfulness is allowing us to develop well what's sometimes described as wisdom. Right,

So what is wisdom? It's the ability to choose the appropriate thoughts, emotions, and behaviors that are going to be adaptive and help you flourish as a human being. So that's where we're at, and I think we're learning really beautiful things about mind in general, as it sits in contemplation and in silence, whether you're a novice practitioner or

an advanced practitioner. We are doing the research right now that will illuminate what is happening in the mind of a meditator as they advance from a novice to an advanced practitioner. Well, I can't wait to hear what you find. Yeah, well, what are some of the main challenges for investigating mindfulness through neuroscience or the field can templative neuroscience? You know, looking at pretty pictures of brain scans that are just

averages over many, many people. Is that really elucidating? You know, I like playing Devil's advocate. By the way, I hope you realize that. Yeah, it's great. In fact, if you want to play Devil's advocate, you can talk about people who in the field who are pushing back against mindfulness and saying, you know, what is this really good for? Is it good for anything? You know? There are certainly limitations, and you mentioned one. You know. Construct validity is an

important thing in psychological research. If you are studying a construct, whether it's cardiovaster disease, awareness or mindfulness, you need to have an operational definition that's consistent and can be not only defined but measured, So operationalizing these constructs are a challenge from any level of analysis, whether it's psychological in nature, which usually is self report measures, or it is or it's defined by the objective means by which we observe

the phenomenon. So we can observe mindfulness as a state paying attention to the present moment and what that looks like using neuroimaging tools, and like you said, you know, seeing blobs on a screen on a picture of a beautiful brain may look pretty, but for a neuroscientist we

realize that it's a bit of a black box. A lot of its reverse inference, meaning we're using a reverse logic to understand function by looking at changes in chemodynamic magnetic properties of the blood really mean for brain activity and function, because all brain activity, of course is electrical and chemical, and we're measuring changes in magnetic properties of blood up as our way to create these blobs of fMRI analysis. And just you know, no, two signals of

form uri are often the same. Do the same task, same person in the same day in different MRI scanners, and you may get totally different activation patterns depending on what they're actually doing. But paying attention mindfully is a very complicated construct, So there are it takes a lot of iterations, a lot of trials to figure out exactly what brain areas are going to be consistently activated for particular styles of practice. And like you're alluding to, neuroscience

is lumping. Just like everything or all the other modalities

of science. We lump. We take all data, we put them into one group, and we look at mean averages, right, so we know that there is outliers, we know that there are individual differences, and until we start improving our methods to focus on individual differences, we're going to have a problem and scalability, Like how do we better understand what's happening in each individual's brain if we're just always regressing to the mean, And that's not going to be

very informative. So there's definitely a lot of improvement in methodology from neuroscience point of view, and in MINDFULSS research that I look forward to just seeing emerge. I love that. And mindfulness is not the be all and end all of everything, right, so it's also not the only source

of wisdom. You know what I mean, just trial and error, like brute trial and error, Like, yeah, the whole toolbox of wisdom doesn't just start an end with mindfulness, right, Well, I mean I would say that that mindfulness is one tool in the toolbox, right, thank you. There are other tools you can use constructively to better understand one's mind

and to draw wisdom. Right. So, and I do think you know, like arist all, the contemplation is a strong skill, a strong tool to use to not only achieve wisdom, which we can debate what wisdom is, but also to, like we said in the beginning, get a better insight into the nature of mind. What is your mind? Where does it go? And having that awareness is liberative in its own sense. Right, You're you're liberating your own self because you're you're no longer just an automaton. You're doing

you're not just doing things. You're actually aware of your own thoughts and emotions and behaviors. And and we say always awareness is it is half the battle? Right g I, Joe, did you just say that I think the knowings half the battle? Right? I love that. Okay, I'm gonna ask you one last question. Yeah, sure, So let's say that like someone who's listening to this who's been meditating for many years and it's had enormous benefits for them in

their personal life. Listening to this podcast, they're like, you know what, I don't really care about the science, Like what do I care about the science? You know? Do I have to wait another twenty five years to see what a study comes out whether or not I should keep meditating? You know? What do you kind of say to that kind of thing, like how do you defend doing the research you do? I mean, well, I mean I tell people, if you're not achieving benefit, if you're

not feeling any benefits, then don't do it. It's that simple. You know, you want to feel that you're getting better, and sometimes you know, it's a matter of effort rather than effort and patience because the effects are accumulative or cumulative, so they may take time, but you have to practice. And that's often, you know, not in the repertoire of American cultures to practice anything. They just want quick fix,

give me, Oh, I want transcendence. So to those people, I'll say, there are technologies that are being developed to stimulate your rain, not invasively, so you can maybe achieve some of the benefits without having to practice, So that may happen, and there may be some pharmacological influences cebety oil exactly. There you go. You know we're learning. I think you know whether even indogenous cannabinoids may be involved

and say, for example, moderating pain. So mindfluss may actually be activating through or functioning through a mediator, meaning it's moving through a secondary factor, which could be CBD or endocannabinoids. So you have naturally occurring cannabinoids in your brain without ever having smoke pot in your lifetime, right, so those cannabinoids are definitely involved in anxiety and modulation of pain.

We don't know its relationship to mindfulness. There are some preliminary studies suggesting there's a relationship between mindflus and canabinoids. So it wouldn't surprise me if you know, in six months we see the next paper that says, you know, add your CBD to your mindfless practice and your you know pain will go down further. So do you think the science is important then? To help point us in the direction I'm trying to answer the question for you,

I'm saying, what is the points here? So I do think that we are early days, right, and the science for our culture. You know, science produces evidence based medicine. If you're a Buddhist practitioner, you don't need science. Do your Buddhism, do your spiritual path. Devotion in your Guru is enough. But for those people who go to your doctor and say, I'm distracted, I have stress, I have

pain and anxiety, what do I do? The research is helping to identify which practices are going to function best for which type of individual. We're going to optimize the delivery of those practices. So you now get your mindfleness in a group an eight week class. You can get it in an app, so a mobile app like insight time or ten percent Happier Calm. You know, all these different apps are out there. We don't know if they're as effective as the eight week course group course one

on one mindfulness. We don't know. We're doing a study right now looking at how one on one mindfulness for chronic low back pain may be effective or not versus spinal manipulation therapy, which is another Yeah that sounds painful, right, but for some people that may be better, and we don't know that, So we want to figure that out. So I think what we're size is good for is

eminis based medicine. We're learning how to identify the mechanism by which these practices function, improve the rigor in which we understand how mindfless works, may it it more individualized in the approach, and to optimize how it's delivered to treat very select populations. Beautiful. Thank you so much, David for taking such a messy field and making it more coherent, and also taking all of the hype and helping us mind the miightenfulness hype a bit more so. Thank you

so much. It's my pleasure to talk to you today, Scott, and I hope if anyone has any questions, it could always reach me at Contemplative Neurosciences dot com. There's a lot of resources there. Thank you, David. That's great. Thanks for listening to the Psychology Podcast. I hope you enjoyed this episode. If you'd like to react in some way to something you heard, I encourage you to join in the discussion at the Psychology podcast dot com. That's the

Psychology Podcast dot com. Also, please add our rating and review of the podcast on iTunes. Thanks for being such a great supporter of the podcast and tune in next season for more on the mind, brain, behavior, and creativity.