Neuroscientist David Vago begins each day with meditation. Like millions worldwide, Vago sees his mindfulness practice as good medicine holistically promoting health. Inspired by the staggering power of the human mind, Vago has studied the neurobiological mechanisms of mind-body practices for almost 15 years.
Mindfulness – a moment-to-moment, nonjudgmental awareness of one’s internal states and surroundings – boasts benefits ranging from stress reduction to enlightenment. However, scientific investigations of mindfulness paint a complex picture. Yes, it can boost physical and psychological well-being. But it is not a panacea and can even be counter-indicated for certain individuals. Despite significant progress over the past two decades, research on mindfulness is still riddled with various conceptual and methodological challenges. This is why, according to Vago, the question What does mindfulness really do? has no simple answer.
Mindfulness Is Far More Than Following Your Breath
Scientists like Vago study the effects of mindfulness by enrolling participants in eight-week interventions. There are four core practices in a mindfulness-based intervention:
- Focused attention. Mindfulness of breath or a body scan.
- Open monitoring. Being aware of thoughts arising and passing without attaching to them.
- Movement-based practices. Hatha yoga or walking meditation.
- Informal practices. Showing up with mindfulness in day-to-day life. Sometimes, the interventions can include constructive practices (loving-kindness meditation) that help individuals construct positive psychological states.
What about these practices that, moment by moment, begin to shift things for people? According to Vago, the possibilities are profound and consequential: people can get more insight into the workings of their minds; hone their ability to respond rather than to react to circumstances; gain glimpses of non-dual states; renew their understanding of the self and its place in the world; feel a deeper connection to others. “This is the Buddhist prescription for a flourishing life,” says Vago. “Everything else – the improved health and the calm – are merely side effects.”
The Gift of Paying Attention
One of the core faculties that mindfulness hinges on is attention. Attention might not have the buzzwordy flair of mindfulness. Yet, it’s one of our most precious resources. Attention, according to the father of modern psychology, William James, is somewhat of a curator of our lives (“My experience is what I agree to attend to.”) Poet Mary Oliver called paying attention “our endless and proper work.”
“Instructions for living a life:
Tell about it.”
Philosopher Simone Weil considered attention “the rarest and purest form of generosity.” “Attention, taken to its highest degree, is the same as prayer. It presupposes faith and love,” wrote Weil. Attention can even alter the perception of another limited human resource – time. As haste and demands leave many of us with the depleting feeling of weeks slipping by, attention can act as a salve to slow down the perceived passage of time (“The best way to capture moments is to pay attention,” wrote Jon Kabat-Zinn, the founder of mindfulness-based stress reduction.)
Perhaps, then, one of the gifts of mindfulness can be found in nurturing our faculty of attention – to move it more nimbly, with more ease, between the micro and macro of our circumstances. To direct its precise lens on a single cherry blossom’s pale, velvety petals and cast its vast reach beyond all boundaries. To discern content (thoughts, emotions) and context (relation to thoughts and emotions). To revel in the wonder that we are alive at this very moment, together with billions of other sentient beings near and far the blooming trees. This reminder will likely kindle a profound appreciation: for our impermanent existence and our affinity with others.
Here’s David Vago, on how mindfulness meditation affects the mind-brain-body.
MP: How does mindfulness benefit health?
DV: The most well-established health benefits of mindfulness meditation include a decrease in blood pressure and perceived stress, an increase in heart rate variability, and an improvement of inflammatory markers.
Mindfulness has also been shown to help with pain management. The experience of pain has physical and emotional components. While we can’t escape the physical effects of pain on the body, the emotional side (for example, catastrophizing pain) can be reduced through meditation. Namely, by impacting attentional biases, meditation can shift the way we attend to pain. For example, people with chronic pain conditions like fibromyalgia can begin to approach pain-related, fearful stimuli, which can help them become less hypervigilant, less avoidant, and less reactive to environmental pain-related signals.
In our lab, we are exploring the glymphatic system – a brain system associated with clearing metabolic waste. One of the ways that sleep benefits us is by eliminating toxins from our brains. Our findings show that by impacting the glymphatic system, mindfulness meditation – a low metabolic state – can act similarly to sleep and have restorative effects on brain functioning.
MP: How do mindfulness intervention outcomes compare to other treatments like therapy?
DV: Overall, mindfulness improves various outcomes related to emotion, cognition, and the self (for example, rumination and empathy) – if we compare it to doing nothing else. Compared to treatments like SSRIs, anxiety drugs, or Cognitive Behavioral Therapy (CBT), mindfulness interventions work as well as these gold-standard treatment modalities but don’t often outperform them.
MP: Does mindfulness change the brain?
DV: Meditation instigates morphological changes in the brain. The challenge is quantifying them. Because the brain responds to every learning experience, it’s always changing. You’re always learning – no matter what you’re doing – thus, your brain is always changing. While there are different neuroscience methods to investigate how the brain changes shape and size, it’s difficult to show these changes in healthy individuals. In fact, it’s controversial what actually changes. However, for brains that have significant atrophy (for example, adults over 65 or brain trauma patients), morphological changes are detected more readily. This is in part because many atrophy processes are based on inflammation and meditation improves inflammation markers.
Functionally, brain imaging shows that mindfulness can activate the brain’s insula, the dorsal anterior cingulate, and the frontal-parietal network. The frontal parietal network is a group of brain structures that are critical for flexibly switching between processing the external world and the internal world. This helps us not get stuck in our thoughts. Often, our thoughts can have the quality of “stickiness.” For many of us, our most common thought is some version of “I’m not good enough.” We spend half of our lives in our heads, repeating to ourselves the various ways how we are not enough. These thoughts have us convinced that we are failing at some unachievable standard set by ourselves and society. As we elaborate on them, they start sticking. Hence our habit of rumination.
Mindfulness meditation helps develop the capacity to toggle between our thoughts and what’s happening in the world. The frontoparietal network also helps support meta-awareness – knowing where our mind is at any point. Moreover, research shows that individuals who develop high trait mindfulness can better regulate their emotions by increasing prefrontal activity and decreasing amygdala activity.
Whether or not meditation increases brain size has to do with preventing age-related atrophy in the brain. Most of meditation’s effects on cognition – executive functioning, attention, memory – don’t necessarily improve those skills in healthy individuals. It’s not like if you practice a lot of meditation. You’ll get super memory or outstanding decision-making abilities. Instead, brain areas that show increases in size with meditation are simply not atrophying in normal age-related ways.
After age 22, everyone’s cognitive capacities begin to decrease. We can see this as atrophy in specific regions in the brains of older adults. Thus, those older than 65 show the most increased brain size from an eight-week mindfulness course since meditation helps stabilize their cognition and prevents decline. The brains of older meditators don’t atrophy like most healthy, aging individuals because they are strengthening their abilities to keep those crucial brain areas active.
Many thanks to David Vago for his time and insights. Vago is an Associate Professor and visiting faculty at the University of Virginia’s Contemplative Sciences Center, Research Lead for the well-being app RoundGlass, and Director of Neurosciences for the International Society for Contemplative Research.
Ponte Márquez, P. H., Feliu-Soler, A., Solé-Villa, M. J., Matas-Pericas, L., Filella-Agullo, D., Ruiz-Herrerias, M., … & Arroyo-Díaz, J. A. (2019). Benefits of mindfulness meditation in reducing blood pressure and stress in patients with arterial hypertension. Journal of Human Hypertension, 33(3), 237-247.
Van Dam, N. T., Van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C. D., Olendzki, A., … & Meyer, D. E. (2018). Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on Psychological Science, 13(1), 36-61.
Wittmann, M., & Schmidt, S. (2014). Mindfulness meditation and the experience of time. Meditation–neuroscientific approaches and philosophical implications, 199-209.
Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., … & Maglione, M. A. (2017). Mindfulness meditation for chronic pain: systematic review and meta-analysis. Annals of Behavioral Medicine, 51(2), 199-213.
Nardi, W. R., Harrison, A., Saadeh, F. B., Webb, J., Wentz, A. E., & Loucks, E. B. (2020). Mindfulness and cardiovascular health: Qualitative findings on mechanisms from the mindfulness-based blood pressure reduction (MB-BP) study. PLoS One, 15(9), e0239533.
Zollars, I., Poirier, T. I., & Pailden, J. (2019). Effects of mindfulness meditation on mindfulness, mental well-being, and perceived stress. Currents in Pharmacy Teaching and Learning, 11(10), 1022-1028.
Christodoulou, G., Salami, N., & Black, D. S. (2020). The utility of heart rate variability in mindfulness research. Mindfulness, 11, 554-570.
Bower, J. E., & Irwin, M. R. (2016). Mind–body therapies and control of inflammatory biology: A descriptive review. Brain, Behavior, and Immunity, 51, 1-11.
Klimecki, O., Marchant, N. L., Lutz, A., Poisnel, G., Chetelat, G., & Collette, F. (2019). The impact of meditation on healthy ageing—the current state of knowledge and a roadmap to future directions. Current Opinion in Psychology, 28, 223-228.