Real Changes with Mindfulness

Mindfulness changes the brain. Nonjudgmental awareness of the present moment includes noticing inner thoughts, images, sensations, and memories, as well as external stressors. Self-processing gradually transforms into equanimity, or Pali for the state of "watching things as they arise." Equanimity expands one's ability to be with whatever comes up with less reactivity, stress, and self-criticism. And when we can notice our own self, we can notice another.

Mindfulness changes activity and connections within subdivisions of the prefrontal cortex (PFC). Studies show changes in gray matter volume and density compared to non-meditators. Increased activity in these frontal areas suggests improved integration in networks.

Connections enhance the capacity to regulate– alertness, arousal, executive functioning (DLPFC and dACC); attention and intentional behavior (OFC); goal-directed activity, integration of sensory input with subsequent behavior (lateral areas); attention to social interaction and relationships (DLPFC).

Abnormal gray matter concentration and activation in the lateral areas (left sgACC) correspond to vulnerability to dysfunctional emotion regulation; dysfunction here increases the chances of depression symptoms.

The PFC connects with the limbic system, or deeper areas of the brain involved in emotion processing, through the uncinate fasciculus (UF). This structure demonstrated significant neuroplasticity. These are the tracts toward emotion regulation, and ultimately, self-regulation.

Transformation occurs cumulatively; experienced meditators show the largest activation reductions. The mindfulness practice of describing and labeling actually disrupts amygdala activity, dampening stress and fear. Lateral areas become more active (VLPFC) and attenuate this activity in the amygdala. Social anxiety patients show more rapid decrease in activation of amygdala in response to negative self-beliefs after a MBI. Increased cortical thickness suggests decreased stress, less negativity, and better ability to monitor and express emotions related to pain (dACC).

Mindfulness observing and non-attachment also lead to physiological changes of homeostasis. The insular cortex connects limbic, frontal, and sensory pathways for executive control to the thalamus, HPA axis, and brainstem for further transmission through the vagus nerve. Sympathetic tone is reduced and the hypothalamic-pituitary-adrenal (HPA) axis is suppressed. Studies show a decreased stress response and then a rapid return to physiological and emotional baseline in response to real threat. All physiological parameters of stress decrease. Rapid physiological regulation is an objective measure of equanimity. Meditators with >2 years experience more rapid decrease in skin conductance after aversive stimuli, and decreased startle amplitude.

We recognize mindfulness as a way of being, and as an essential component of DBT, ACT, even "being with" another in the therapeutic alliance. We have added further evidence that psychosocial interventions lead to real biological, life changes.