by Jennifer Wolkin | Oct 23, 2015 | Mindfulness, Wellness
I am so grateful that my review regarding the mechanisms behind mindfulness’s positive impact upon psychological well-being was recently published by Dove Medical Press (with a video included!)
The following blog post is based off that review.
Let’s Thrive! – Dr. Wolkin
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This blog post originally appeared on Mindful.Org
There is a lot of research conveying mindfulness meditation’s positive impact upon psychological well-being. In fact, a vast literature of controlled studies has found that mindfulness meditation is related to improved mental health across a variety of disorders, including different anxiety disorders, depression, eating disorders, substance abuse, and chronic pain symptom reduction.
Yet, the idea of mindfulness has become a buzzword of sorts, and despite research regarding positive outcomes, specific mechanisms associated with mindfulness and psychological well-being are unclear. (Additionally, the ambiguity in the term mindfulness, and how it’s approached in research, makes it difficult to parse out particular mechanisms responsible for clinical outcomes.)
Mindfulness and Attention Mechanisms
Despite these limitations, many research studies seem to indicate that cultivating different aspects of attention is a feasible and consistent starting point to bridging mindfulness practice and psychological well-being.
The question remains: How can cultivating multiple aspects of attention through mindfulness meditation account for psychological well-being?
This blog post is based on a review that supports a previously suggested idea that cultivating all aspects of attention through mindfulness leads to greater well-being by decreasing rumination.
Attention Networks
Like mindfulness meditation itself, attention is not easily defined. Over two decades ago, researchers conveyed a conceptualization of attention as a multifaceted construct made up of the three unique and differentiated, yet overlapping networks called Alerting, Orienting, and Executive Attention—the latter includes regulatory processes like conflict-monitoring and metacognition.
Attention Regulation
Attention is also described in terms of the way it is regulated. In fact, meditation practices are usually described by the degree to which they entail “Focused Attention (FA)” and “Receptive Attention (RA).” Although sometimes likened specifically to RA, mindfulness practice is distinguishable by its utilization of both FA and RA.
Focused Attention: When our attention is focused, it is restricted to a specific object, which is commonly the neutral sensory experience of the breath going in and out.
Ideally, attention is sustained, but as thoughts, and/or feelings and/or physical sensations arise, a conflict is presented; different stimuli are pulling for attention.
Receptive Attention: After consistent practice, there is often less need for a specific object of focus (the breath), and we broaden the focus of our attention so that it is receptive to our entire field of awareness, including whatever thoughts, feelings and sensations arise in the moment.
Rumination: Rumination has been defined as a passive dwelling upon negative thoughts and/or emotion and is negatively correlated with aspects of psychological well-being.
As mentioned, this review supports mindfulness meditation’s role in improved psychological well-being, through the mechanism of reducing rumination via attentional processes.
The question remains as to how this actually plays out.
Distraction and Decentering
Rumination is decreased through a two-step process including distraction and decentering. These steps correspond to the attention regulation styles inherent to mindfulness meditation.
Early on in one’s mindfulness meditation practice, when it entails focused attention, attention is sustained on the neutral sensation of the breath. While this skill is being cultivated, ruminative thought processes likely interrupt the effort to sustain this attention.
The ability to monitor conflicts of attention, however, ensures that one is constantly distracting oneself from ruminative thoughts through the redirection of attention from rumination back to the breath.
According to the research, distraction is a healthier response to stress than rumination and entails a deliberate direction of attention away from ruminative thoughts onto a pleasant or neutral stimulus. Yet, research also indicated that although distraction is important, it only serves as temporary relief, because with distraction, avoidance is taking place.
In the long term, avoiding and pushing away thoughts through distraction is as inefficient as clinging to them through rumination. So, there is a process beyond distraction. Mindfulness meditation utilizes the benefits of distraction, but then goes beyond it in cultivating a more adaptive response to distress.
This is enabled through receptive attention, during which attentional focus is broadened and one is encouraged to be aware of all experiences. One now has the space to actually notice patterns of over-engagement in negative thoughts as opposed to suppressing them through distraction.
The ability to cultivate a broader range of awareness also cultivates the ability to decenter, which is enabled through enhanced metacognition, and allows for a stepping back from any possible secondary elaboration of ruminative thoughts.
This means that thoughts are nonjudgmentally accepted as just thoughts that come and go. When thoughts are seen as transient, one is more likely to feel disconnected to them.
How Mindfulness Meditation Creates a Shift
The idea inherent in both distraction and decentering is that a shift is taking place. During the former, one’s ability to distract and redirect attention away from rumination and to sustain attention on the neutral breath is a literal shift in attention that cultivates regulatory processes intrinsic to psychological well-being. During the latter, one has the opportunity to figuratively shift attention from the content of a thought toward the process of having one. That vantage point allows for a more objective and less judgmental perspective. This perspective is more adaptive and reflected in greater psychological well-being. Ultimately, engaging in mindfulness meditation cultivates our ability to both focus and broaden our attention, which is a practical way to elicit psychological well-being.
by Jennifer Wolkin | Aug 31, 2015 | Brain Health, Mindfulness, Wellness
Just to reiterate:
The body is composed of more bacteria than it is cells. Collectively, the trillions of bacteria are called the microbiome. Most of the microbiome reside in our gut, and is sometimes referred to as the gut microbiota. We all have our own unique microbiome. A healthy gut can be different iterations of bacteria for different people, because it is this diversity that maintains wellness.
The microbiome is capable of playing a vital role in physical and psychological health via its own neural network, the enteric nervous system (ENS), sometimes referred to as the second brain.
A shift away from “normal” gut microbiota diversity is called dysbiosis, and dysbiosis may contribute to disease. In fact, alterations in the diversity and stability of the gut microbiome has been linked to many diseases, including autoimmune, gastrointestinal, and even brain disorders.
The microbiome is capable of playing a vital role in physical and psychological health via its own neural network, the enteric nervous system (ENS), sometimes referred to as the second brain.
Given the far-reaching health implications that the ENS is now understood to mediate, treatment for many neurological, neuropsychiatric, autoimmune, and gastrointestinal difficulties have taken a new turn. Perhaps one of the best ways to boost our brain is by maintaining impeccable gut health. So to, for functional GI disorders, it might be impossible to heal a distressed gut without considering the impact of stress and emotion.
This all begs the question: What are some lifestyle choices we can make to foster optimal mind-body-brain wellness? I have many suggestions, but in this post, I want to focus on one specific technique that will efficiently elicit holistic benefits: mindful eating.
Mindful eating, in my opinion, speaks to being mindful of both what, and how, we eat. Paying attention to what we put into our mouths protects us from choosing the types of foods that are particularly toxic to both our gut and brain. For different people, different foods are more or less inclined to cause dysbiosis. Generally speaking, however, the more processed the food, the more noxious.
Mindless eating can wreak havoc on our digestive abilities by eliciting stress hormones, and therefore can add pounds, take away pleasure, and maintain functional gastrointestinal difficulties. In contrast, eating mindfully reduces our stress hormones, and gives our body the time and space it needs to thoroughly digest food, without the inflammation.
Aside from reducing stress hormones, mindful eating enables us to slowly and sensually savor the action of eating, creating an experience to delight in. It also allows us to engage with our inner sense of satiety, which helps curb the over-eating that leaves us feeling uncomfortable.
Mindful Eating for the Brain and Gut
Keeping all of this in mind, here are five (A,B,C,D,E) ways to begin a mindful eating practice.
1. Ask
When it comes to mindful eating, we don’t have to have a set formal practice. We can initially begin by asking ourselves some key questions:
• Why am I eating now: am I hungry, or craving something else?
• What am I eating now: will this choice serve my wellness in some way or will my body and mind regret this choice? You can think of this question as a cost-benefit analysis. It is OK to treat yourself to something that isn’t necessarily the healthiest choice, if it is in moderation. Yet, ask yourself if it is worth it, or will it wreak havoc to the point at which it is no longer even a treat?
• What else am I doing now: am I about to eat something while I also read an article, or watch TV, or have a conversation? Give yourself permission to JUST eat.
2. Be grateful
Before you lean in to whatever it is you are going to ingest, take a moment to reflect on how grateful you are for being able to engage in this meal. This can be a formal prayer, or as informal as saying thank you in your mind or out loud to the sun, the earth, the farmers, and even the universe for having a hand in delivering this food to your mouth.
3. Chew, and then chew again
Since our actual digestion begins with chewing, taking the time to chew, and then chew again, helps the enzymes in our saliva do its job so that we can effectively absorb nutrients and get the most out of the food we are eating.
4. Dine
There is eating and then there is dining. Many of us don’t have the time to sit down to a formal meal, especially during a busy work day. Yet, dining can be as simple as allowing yourself to experience every sensation of your meal as it unfolds with each moment. Dine by indulging in the different aromas, textures, and tastes of everything you eat, instead of going from bite to bite—or, more often, swallow to swallow.
5. Engage your attention
Whether you are practicing a formal sitting meditation using the breath as your guide, or eating mindfully, a core component to mindfulness practice is engaging your attention, tuning-in, and regulating if necessary. Our minds inevitably wander—that is just a fact of being human. When you are eating and begin to notice the mental chatter and commentary, without judgment, see if you can redirect your attention back to the experience of dining; of experiencing all sensations.
by Jennifer Wolkin | Aug 9, 2015 | Brain Health, Mindfulness, Wellness
This blog post originally appeared, in an adapted form, on Mindful.Org
I don’t know about you, but I feel so much better when my environment is neat and organized. After a long day of work, coming home to a neat space is like coming home to myself. It is a refuge, truly, and I feel soothed.
When I wake up in the morning, before the sun comes up, and stumble to my espresso machine, bleary eyed and still ridiculously tired, a neat space seems to beckon me to use my time in the way I so desire. I try to wake up early to practice mindfulness, set an intention for the day, and then either focus to finish patient notes from the day before, or write creatively…although I’d like this to happen more regularly than it does, I am gentle with myself when it doesn’t.
I do know, however, that there are certain ingredients that will immediately create an impasse for all that to manifest. That is waking up to a messy space. Waking up to a messy space becomes a metaphor for the brain fog and overwhelming feelings that begin to ensue. Decluttering is hard, but it is worth it. The effects impact your mind and body. Some of the behavioral work with my patient focuses on paced organization schedules as well as cognitive work regarding the “letting go” of the clutter that many of us create to protect ourselves. This idea is vast, and I will write a post about that in its entirety at a later time.
My patients find that undoubtedly, as the cutter begins to lessen, they feel a clearing in their minds that they never thought was possible. This is a kind of outside-in decluttering. A physical clearing creates vast mind space. I recommend this extraordinary book to help you get started with the outside in process: “The life-changing magic of tidying up”.
Here’s the thing though, just as we need to declutter our physical surroundings, we need to declutter from the inside-out. I like to call this feat “Feng-Shui-ing the Grey Matter”. Literally, we need to spring clean and give our neural circuitry the room to grow. When this happens, we begin to literally feel the lightness of being.
The irony here: When we declutter, both the environment we inhabit and the minds that sometimes seem to inhabit us, we start to fill our lives with meaning and possibility.
The Brain is now known to be a neuroplastic entity (see my recent Mindful.org post for more on that: “How the Brain Changes When You Meditate“). It is no longer static and by “feng shu-ing the grey matter” we can literally change the neurofunctional space that all the crud and chaos seemed to take up.
Personally, I find this comforting and empowering. What I have found, through my own tedious work, as well as the perseverance of my patients, is that this space is a place where we can mindfully allow for positive Qi to flow within us.
Too esoteric? I hear you. What if I concretized the concept a bit so that we can take actionable steps to feeling better, inside-out.
Ok…here goes.
- Sometimes it seems like all I can do to calm down, to declutter, to make space, is to Take a Vinyasa (flow with breath and body through a sequence of asanas/postures/yoga poses). Sometimes I go from downward dog to plank to upward dog and back. Sometimes I start from a Warrior II pose then straighten my front leg in sync my breath, which is also now in sync to my hands moving from out to the sides to above my head.
- When I am particularly overwhelmed by negative thought clutter, and it seems as though the ruminations won’t end, I Recite a Poem. I literally recite my favorite poem (which I committed to knowing by memory for this VERY purpose), which happens to be Wild Geese, by Mary Oliver. I become so engaged in reciting the poem, mindful of both the rhythm and meaning of the words, that I let go of all other thoughts. My brain can’t BOTH recite a poem and ruminate at once! You don’t have to use a poem…you can use a favorite song, monologue, etc.
- One of my favorite ways to instantly declutter is to literally Bust a Move! I bust out one of my favorite dance moves, and even get the added bonus of the endorphins. I grew up with Tapes, not CD’s, so can anyone say THE RUNNING MAN (or the ELECTRIC SLIDE)!
- While I don’t purport to live in the past by way of having regrets and overanalyzing situations which are long forgotten, I DO like to Mosey Down (good) Memory Lane. I find it such a treat to close my eyes and picture myself at that concert at the Boston House of Blues, that time my dad took me to my first baseball game… peanuts and all, playing my guitar solo in front of an audience, passing my licensing exam, getting those roses…the list can go on and on. I get to go back to that time and place, to feel the sensations as I surrender to sweet nostalgia.
- One of the most effective ways to Feng Shui the Grey is to simply Say Thank You. You don’t necessarily have to have a god, or the universe, or anyone in particular in mind. Just a general “thank you” to express gratitude for everything you are or aren’t, and everything you have or don’t have. This is by no means easy, and I do NOT mean to placate you or undermine any difficulty you are experiencing. But there is actual literature in the field of “Positive Psychology” that expressing gratitude is a huge part of mental health, which includes stress reduction.
For those of us who want to have at least SOME control in such an uncertain life, we can actually make the CHOICE to declutter our minds, and in doing so we actually change the map of our lives.
Let’s Thrive,
Dr. Jen
by Jennifer Wolkin | Jul 29, 2015 | Brain Health, Mindfulness, Wellness
This blog post originally appeared on Mindful.Org
Not too long ago, most of us thought that the brain we’re born with is static—that after a certain age, the neural circuitry cards we’re dealt are the only ones we can play long-term.
Fast-forward a decade or two, and we’re beginning to see the opposite: the brain is designed to adapt constantly. World-renowned neuroscientist Richie Davidson at the Center for Investigating Healthy Minds at the University of Wisconsin-Madison, along with this colleagues, want us to know three things: 1) you can train your brain to change, 2) that the change is measurable, and 3) new ways of thinking can change it for the better.
It’s hard to comprehend how this is possible. Practicing mindfulness is nothing like taking a pill, or another fix that acts quickly, entering our blood stream, crossing the Blood Brain Barrier if needed in order to produce an immediate sensation, or to dull one.
But just as we learn to play the piano through practice, the same goes for cultivating well-being and happiness. Davidson told Mindful last August that the brain keeps changing over its entire lifespan. And he thinks that’s very good news:
We can intentionally shape the direction of plasticity changes in our brain. By focusing on wholesome thoughts, for example, and directing our intentions in those ways, we can potentially influence the plasticity of our brains and shape them in ways that can be beneficial. That leads us to the inevitable conclusion that qualities like warm-heartedness and well-being should best be regarded as skills.
Davidson adds that research on neuroplasticity gives neuroscientists a framework for tracking meditation research. And CIHM is beginning to see that “even short amounts of practice,” like 30 minutes of meditation per day, “can induce measurable changes in the brain” that can be tracked on a brain scanner.
Based on recent research, I’ve chosen to share four ways your brain may change when you practice mindfulness:
• Anterior Cingulate Cortex: Increased grey matter changes were noted in the anterior cingulate cortex (ACC), which is a structure located behind the brain’s frontal lobe. It has been associated with such functions as self-regulatory processes, including the ability to monitor attention conflicts, and allow for more cognitive flexibility.
• Prefrontal Cortex: Increased grey matter density was also found in areas of the prefrontal lobe, which are primarily responsible for executive functioning such as planning, problem solving, and emotion regulation.
• Hippocampus: Increased cortical thickness in the hippocampus has also been noted. The hippocampus is the part of the limbic system that governs learning and memory, and is extraordinarily susceptible to stress and stress-related disorders like depression or PTSD.
Decreased Amygdala Size:
Studies have shown that the amygdala, known as our brain’s “fight or flight” center and the seat of our fearful and anxious emotions, decreases in brain cell volume after mindfulness practice.
Diminished or enhanced functionality in certain networks/connections:
Not only does the amygdala shrink post mindfulness practice, but the functional connections between the amygdala and the pre-frontal cortex are weakened. This allows for less reactivity, and also paves the way for connections between areas associated with higher order brain functions to be strengthened (i.e. attention, concentration, etc.).
Reduced activity in the Brain’s “Me” Center:
Mindfulness practice has been implicated in the decreased activation and the stilling of our Default Mode Network (DMN), which is also sometimes referred to as our wandering “Monkey Minds.” The DMN is active when our minds are directionless as it goes from thought to thought, a response that is sometimes likened to rumination and not always adaptive with regards to overall happiness.
The impact that mindfulness exerts on our brain is borne from routine: a slow, steady, and consistent reckoning of our realities, and the ability to take a step back, become more aware, more accepting, less judgmental, and less reactive. Just as playing the piano over and over again over time strengthens and supports brain networks involved with playing music, mindfulness over time can make the brain, and thus, us, more efficient regulators, with a penchant for pausing to respond to our worlds instead of mindlessly reacting.
by Jennifer Wolkin | Jul 6, 2015 | Mindfulness, Wellness
At the end of each new intake evaluation I always ask my patients to delineate one to three concrete goals for their work in therapy. Many of them don’t even have to give it any thought, and immediately and confidently say: “I want to lose this sense of my fear, and make these symptoms of anxiety go away”.
Yet, from what I have learned through my training, mentors, and my own therapy, and what I tell my patients when they embark on a journey to rid themselves of anxiety and fear…
Not only is it impossible to rid yourself of these feelings, it is detrimental. The point of therapy isn’t to “fix” you, or to make your feelings go away, but rather to help you learn the skills to enable yourself to bring those feelings into balance, to an adaptive level, where they belong.
Fear, you see, is evolutionary. The fact that our fight or flight mechanisms arouse us to impending dangers or threats is a gift. Anxiety, which is similar to fear, but engages more of the thinking part of our brain, is also just as adaptive. If we never got anxious, we’d never go to the doctor, study for an exam, make sure we have a retirement plan in place, or pay our electric bills. In fact, anxiety is linked to conscientiousness, and conscientiousness is linked to longevity.
Yes, the inability to feel anxious can shorten your life! So, by that logic, anxiety is life-promoting!
Here is the thing to remember though. It is about working to keep the anxiety and fear at adaptable levels, and to live not in spite of these feelings, but because of them!
I personally struggle with the balance of adaptive and less adaptive anxiety all the time. Here’s just a little example:
A few weeks ago, I woke up at 4am. I couldn’t sleep – at first, I didn’t really feel much of anything. I just lay in bed, not knowing what to do, so I just looked up at the ceiling. I finally got up and walked around, shut the light, opened the light, shut the light, got some water, went back into bed, got out of bed, and at that point I was starting to cycle through some very destructive and fear-induced thought processes. I was starting to feel mentally and physiologically stressed, but then…
here was my moment…
I put my sneakers on and I could feel some sort of new adrenaline rush inside me, not a toxic one, but one that lifted me up (there’s a fine line between these adrenaline rushes, different mindset, but same ‘ol physiology). Whether I was excited or stressed, my fight or flight was elicited. I think the interpretation of what it means is the difference between the biophysiological and psychosocial consequences of the rush.
This rush catapulted me to the gym, finally feeling energized enough to exercise. I nearly skipped all the way there, and when I arrived the sight of sweaty people elated me – so many people alive and moving and motivated to heal and live longer by bringing their heart rate up, or combating obesity, or high blood sugar, or just general malaise, or a depressed stupor. I was inspired by this tableau, which touted the need for social milieus to act out the yearnings of the mind and body to thrive. We were all acting on our fears together.
Fear and anxiety are the human struggle, and the struggle is real. My therapist encourages me, and I in turn encourage my own patients, to embark on living a healthier life, the life they desire, by embracing their fear, without letting it cripple them. And fear, can most definitely cripple.
Many people have said, “Use fear as fuel”, and while the catchphrase might be cliché, it couldn’t be truer. There is nothing to rid ourselves of, only everything to embrace…
What has your experience been? Are you up for embracing your fear and working WITH it?
Let’s embrace all of ourselves; especially those BrainCurves :).
– Dr. Jen