Thank you very much. It's a pleasure to be here today
and to give you a taste of the work that we've been doing, and
discuss its implications for what many of you may do in the
broad domain of spiritual care. I don't know the details of
people's background here. And I may drift into things
a little bit technical. But I'll try to skip over them
if I see some glazed eyes, and make sure to leave some time
at the end for questions, which I suspect will be
particularly interesting. So what I'm going to talk about
today is our research on meditation and what it may imply
for spiritual care in healthcare settings in particular.
And I want to frame this in the larger context
in which this work is occurring. So this was the cover of
the Time Magazine issue on the Science of Happiness
that was published about a year ago, in which some
of our work was featured. This kind of stuff is very much
in the news. This was the cover
of a National Geographic. And this photograph
was taken in my lab. This is a Tibetan Buddhist Monk,
who is being set up to have his brain monitored
while he engages in particular kinds of meditation practices.
This is the cover of a program, a meeting, a small meeting,
that I was asked to organize for the Dalai Lama that was held
at his home in India on the theme of neuroplasticity.
Neuroplasticity in the idea that our brains can change
in response to experience, can change in response
to training. And this really is probably
one of the most central findings, if you will,
or most central themes in neuroscience
over the last decade. There are many different
mechanisms of neuroplasticity that have been discovered,
but the way that we think about the impact of certain kinds
of practices, like meditation, as it may affect an individual's
behavior and experience, is through its effects on
plastic changes in the brain. The work of this kind,
I believe, will place this on a much firmer scientific footing
so that the healthcare establishment will indeed
take these practices much more seriously, because a scientific
mechanism for them will be much more well understood.
This is just some pictures from that meeting in India,
which was held a couple of years ago.
And speaking in the hot seat next to the Dalai Lama
is truly an amazing and unusual experience,
different than any other kind of scientific talk.
This is what the room looks like there.
In fact, I just got back this past weekend.
We had a meeting with the Dalai Lama at Emory university
on the theme of compassion and depression,
where we showcased some of the recent scientific evidence
in that area. It was really a spectacularly
successful and interesting meeting with about 3,500 people
in attendance. So, there are two points
that I want to make in my talk today, two big points.
The first point is that people differ in their levels
of happiness, and things related to it, including qualities
like loving kindness and compassion.
And these differences are associated with different
underlying biological characteristics.
The second big point that I will make is that happiness,
compassion and loving kindness can all be regarded
as the product of skills that can be enhanced in training.
And that this training induces plastic changes in the brain.
And these changes also have effects on the body in ways
that may be consequential for physical health.
So those are really the two broad points
that I want to make. Everything else is really
a footnote to these two points. I want to remind all of you
though, that in our country in particular, in addition
to being a state, or a trait, or a skill, happiness
is an inalienable right. Something that may be
not so apparent in the current environment,
and with our current political administration.
But these indeed are the words penned by Thomas Jefferson,
which you all know. But it doesn't hurt to remind us
that this is one of the founding principles upon which
our country is based. Now I want to just very briefly
show you at the outset that happiness, and qualities
like this are not just ephemeral mental states,
but they also have consequences for morbidity and mortality.
This is from a Finnish longitudinal study that was done
a number of years ago with about 30,000 individuals
who were followed over the course of a 20-year period,
where investigators monitored their level of happiness.
And people here are divided from very happy
to very unhappy, and then followed over
this 20-year period. People who reported themselves
to be very unhappy over this 20-year period
were more than ten times likely to actually commit suicide.
So the qualities of happiness are something to take seriously.
This is a more recent article that was published in the
proceedings of the National Academy of Sciences
from a group in the U.K., where they were specifically
monitoring levels of happiness and well-being, and looking at
specific immune, endocrine and cardiovascular indices
that are very importantly related to health.
In this large sample, they found that individual's
level of happiness was strongly associated
with each of these domains, and suggests that, again,
these qualities have potentially very important consequences
for health. And so it's not just trying
to make a patient feel better subjectively, trying
to increase their well-being, but that these changes
that you may be able to induce in patients
will likely change the brain and have downstream effects
on their biology, which may be beneficial for health.
So that is a central theme of this work.
I want to just show you at the beginning some fun slides
that relate to this issue of the malleability
of happiness and other characteristics.
In the next three slides, I'm going to show you
are based on real data. I promise you,
I did not make them up. But they serve to illustrate
a very important point. So we're going to ask
the question whether social and economic factors
modulate our level of happiness. So the first question
is whether marriage buys you happiness.
And here's the answer. If you get married
at this point, again, these are real data based on
tens of thousands of people. This is a measure
of life satisfaction, a proxy for happiness.
At the time you get married, there's a big boost
in your happiness. But look what happens
as you get further from the time you get married.
So at five years-plus, you're actually doing worse
than before you started. Now these are average data.
I recently celebrated my 31st wedding anniversary,
and I'm very happily married. So there are many violations
of this normal pattern. But this is in fact, what
the data say in our culture. The related question
is whether widowhood produces unhappiness.
And here's the answer. ( laughter )
So again, you take a big hit. But you come right back
down to baseline. Now, of course, the question,
which is a question that our culture is particularly
obsessed with, is the question of whether money
can buy you happiness. Here's the answer to that.
So if looking from 1945-2000, if you plot the real income
per head in the United States, our country has been,
by and large, spectacularly economically successful.
If you superimpose upon that the percentage of people
who report themselves to be very happy in our country,
it's flat. It's absolutely unrelated
to the economic success. Now it's not to say that money
is completely unrelated to happiness.
If you look across cultures, those countries that are doing
much, much worse, in fact, are also worse
in terms of levels of happiness. But within western culture,
and countries that are part of western industrialized
democracies, there is no relation between money
and happiness. So where does that leave us?
Can happiness, compassion, and loving kindness
be enhanced or are we all stuck
at our respective set points? And I'm going to suggest to you
that while the data that I showed you are in fact,
what the data reveal in terms of the relative imperviousness
of well-being and happiness to certain social
and economic factors, that doesn't mean
that happiness and well-being cannot be enhanced.
So the work that we do, I frame within the context
of neuroplasticity. There's a lot of work which
suggests that there are many domains.
I've just listed a few here. One is musical training.
We know that as a person learns to play a complex instrument,
there are actually changes in the brain that are induced
that can be tracked with modern neuroimaging methods,
both structural and functional changes.
So this is an example of how the learning of a complex skill
is associated with important changes in the brain.
Certain motor skills are similar.
There was a recent paper published in the scientific
literature showing that jugglers, as they become masters
at juggling, have induced changes that can be tracked
in their brain. We know from research
at the animal level, that there are profound maternal effects
that can be induced in the brains
of their offspring. The differences that a mother
expresses toward her offspring in nurturance, in love and
compassion, actually induce changes down to the level
of gene expression in the brains of those offspring.
And those changes persist for the entire life
of that organism. These are phenomena that can be
addressed using rigorous scientific methods.
We also know that stress and exercise have effects
on a very recently discovered and extremely important
mechanism of neuroplasticity. And that is neurogenesis.
Neurogenesis refers to the growth of new neurons,
something that even, ten years ago, there was
a lot of skepticism about; 15 years ago, no one believed.
We now know that neurogenesis is a robust phenomenon.
It occurs in all brains. It occurs throughout the entire
life of an individual. And we know that stress
impairs neurogenesis. We also know that neurogenesis
plays an extremely important role in aspects
of learning and memory. So, imagine that there are
two individuals. I've labeled them
"A" and "B" here. And imagine that they're both
exposed to some stressful life event here.
The way I've drawn these curves is meant to illustrate
differences in the rapidity with which these individuals
recover from the stress to which they have been exposed.
So in this diagram, person "B" recovers much more
quickly compared to person "A". We believe that these
differences reflect important features of differences
among people in the capacity to regulate emotions, which
can be tracked using modern neuroscientific methods.
I won't bore you with the details.
But if you show a person a picture like this,
that depicts human suffering and you instruct them,
instead of reacting with disgust or anxiety
to a picture like that, to change their response
so that they have compassion toward that individual
who is suffering, it transforms the way
the brain responds to those kinds of stimuli.
I won't go through the details of this.
But one important area in the brain which is modified
is the amygdala, which we know to be a very important site
for the mediation of negative emotion.
Now it turns out that the differences among people
in their capacity to modulate the amygdala, is associated
with downstream biology, peripheral biology that may be
consequential for health. In this particular study,
we measured the stress hormone cortisol, and found that
the differences among people in how able they are
in regulating their amygdala is actually related
to differences in cortisol profiles, which may be
very important for health. And I'm just going to skip that
in the interest of not boring you with scientific detail.
I can come back if there is interest.
I want to now spend the rest of the time on this question.
What's the impact of more systematic training of the mind
on the signals in the brain that are associated
with emotion. And this brings me
to a very unusual project, which has been going on in
our lab for the past six years. This project was inspired by
my first meeting with the Dalai Lama, which was in 1992.
Then beginning in 2001, we had a string of long-term
meditation practitioners come visit Madison
and spend time in my lab. This is one of them here.
He actually is named Matthieu Ricard.
He's published a number of popular books.
He's been a Tibetan Buddhist Monk since 1967.
He also happens to hold a Ph.D. in Molecular Biology,
where he received that Ph.D. from The Pasteur Institute where
he worked with Francois Jacob, the Nobel Laureate.
So he comes with particularly unusual credentials.
This is another monk in our lab.
This is actually the one that appeared on the cover
of the National Geographic. And when they come to our lab,
we actually spend as much time just conversing with them
as we do in the laboratory, because they have played
a very critical role in helping us actually design
these experiments to make them sensitive and appropriate
to the kinds of practices that they have learned
over the course of the years they have spent
training their mind. This is just a shot of me
giving Matthieu instructions before he begins to meditate.
And this is Matthieu just after he came out of the MRI scanner.
He had been in the scanner for about three hours.
Most people don't look like this when they come out
of the scanner. But he was just radiant
most of the time. This is just a picture
in the lab, in another lab where some of the monks
help us run these experiments. I'll show you just a little bit
of data from these studies. What we've done in some of
these studies is just have the practitioners meditate
for brief periods of time. They are alternated
with a neutral state. And we've probed the meditation
period with, in some cases, strong emotional sounds
that we present during the meditation.
So for example, during compassion meditation,
we've presented very negative emotional sounds,
sounds of a person screaming, for example,
to see what happens in the brain when the individual
is generating compassion and they are exposed
to this kind of adversity, to signs of human
suffering, if you will. So in this work, which is on
the voluntary cultivation of compassion, we've been
studying practices that are central to the Dalai Lama's
mission and his lineage. These guys engage in specific
practices that are designed to cultivate compassion.
And in the words of Matthieu Ricard,
I'll just read part of this. This describes what
the practitioners were doing in this experiment.
What we have tried to do for the sake of the experiment
is to generate a state in which love and compassion
permeate the whole mind, with no other consideration,
reasoning or discursive thoughts.
This is sometimes called pure compassion,
or non-referential compassion. Now you know on television
there are sometimes those commercials,
where they then say, "Don't try this at home."
Well, you can try this at home, but the likelihood is that
if you are relatively untrained, you are not going to be able
to do this, because this is the end point of many, many,
many, many years of training, where the mind gets
very, very focused and is able to do something like this.
Most of us novices are really not able to do this
with any kind facility. Now we have observed
dramatic changes in the brain when the practitioners engage
in these kinds of practices. And this is just the brain
electrical activity during a resting period
and then during a transition to a meditation period.
You don't need, even, any fancy computer signal processing
to see that there's just a very dramatic, overt difference
in the EEG when the practitioners go
from a neutral resting state to a meditation state.
These are dramatic changes. They actually have never been
seen before in the human brain. And we reported them
a few years ago in an article that, a post-doc of mine,
Antoine Lutz, was the first author on.
This just shows from the original article.
At that time, we had eight practitioners,
and ten age-match controls. The practitioners were showing
dramatic increases in these signals,
whereas the controls, who were taught to meditate and were
meditating for a couple of weeks before they came into the study
were showing modest changes at best.
And most of them showed no systemic change at all.
One of the questions that we asked is whether the length
of their meditation training actually predicts
any of these changes that we see in the brain.
And the answer is yes, it very strongly predicts it.
The practitioners that we tested, all had a minimum of
10,000 hours of formal practice. They all had done at least
one three-year retreat, where they were meditating
at least eight hours a day, seven days a week,
for three continuous years. The actual range of practice
in this study went from 12,000 to about 62,000 hours
of practice. There's a very strong relation
between the changes in these signals in the brain and
the number of hours of practice. Now there is a particularly
interesting part of the brain that we've been looking at,
specifically in relation to compassion practices.
It's illustrated in this coronal brain slice.
And it's called the insula. The insula is the only place
in the brain that contains a viscero topic map of the body.
That is, it actually maps the body states
and provides information about what's going on in the body
to the rest of the brain. The insula also has descending
pathways to the body, and can influence the body
in systematic ways. The red lines belong to
the long-term practitioners. The blue lines here
belong to the controls. And this is during the
generation of compassion. And these are evoked changes
in the brain that we detect with fMRI in response
to those emotional sounds that I described.
What you can see is this. That the solid line
is the meditation period. The dotted line
is the neutral period. What you can see is that when
practitioners are generating compassion, there is
a specific enhancement of the insula response
to the emotional sounds. Now that's not the only area
of the brain that's changed. Another area that we've been
particularly interested in is an area of the brain
that has been very strongly implicated in empathy
that has been linked to making inferences about
the mental state of others. And it is an area
that is known as the right temporal-parietal junction.
It's in the right hemisphere, where the parietal and
temporal cortex come together. And again there's a dramatic
increase in activity in this area among
the long-term practitioners-- Excuse me, when they
are generating compassion. Now you may look at this
and say, "Well this is all well and good, but probably
no one here is about to go off and meditate
for three continuous years." So can more short-term training
produce effects which are similar.
And it's our conviction that even small amounts of training
can make a difference. So we're involved now in a study
with just two weeks of training. And this is in rank novices
who receive two weeks of a compassion intervention.
It's a daily practice which they're asked to do.
They're asked to do it for 30 minutes a day for two weeks.
And we have a comparison group that's taught
cognitive reappraisal. This is a therapeutic technique
that's derived from cognitive therapy, which is used to treat
patients with depression. And we actually deliver
the intervention online. And so they log-on
to a protected Web site. And they actually receive
the intervention. And that's a way for us
to monitor the number of minutes per day that they're logged on.
The intervention is delivered by highly experienced
practitioners. And the elements of the
compassion training include the contemplation and visualization
of suffering, and then wishing the freedom from that suffering
for a number of different people, for a loved one,
for themselves, for a stranger, for a difficult person,
and for all beings. And so they are given
that instruction to very intentionally imagine,
visualize the suffering of these individuals,
and then that these individuals would experience a relief
from suffering for each of those categories.
And they do this for 30 minutes a day for two weeks.
They use phrases that they say to themselves.
They repeat silently. The most common phrase is,
"May you be free from suffering. May you experience
joy and ease." And they're specifically
instructed to pay attention to the visceral sensations,
especially in the area of the heart,
that may be elicited by this practice.
They also are specifically instructed to feel
the compassion emotionally and not to simply repeat
the phrases to themselves cognitively.
Those are the essential elements of the intervention.
They go through this training. We put them in an MRI scanner
after they finish their two weeks of training
to see how just two weeks of training
may have changed the brain. What we do in the MRI scanner is
we expose them to these pictures that depict human suffering.
You can think of this as analogous
to a cardiac stress test. When you go to a cardiologist
to have your cardiovascular function assessed, you are
often given a stress test where you would challenge
the cardiovascular system with exercise.
Well, this is a brain stress test.
We are administering stimuli to the person.
In this case to depict these imagines of human suffering,
to challenge the person to see how the intervention
may have affected their ability to deal with
these kinds of stimuli. Now we also administered
a number of self-report questionnaires, one of which
is a questionnaire called the self-compassion scale.
Two of the items on the scale are these.
I try to see my failings as part of the human condition.
When I'm feeling down, I try to approach my feelings
with curiosity and openness. Now on these scales,
after two weeks of training, participants report
significant increases. And we compared it
to the control group, the cognitive reappraisal
control group, which shows no change whatsoever.
We also asked them, after the scan,
to rate the their experiences on a number of different
dimensions. And one of the dimensions
that we asked them about is their willingness or
propensity to want to approach the person in the picture
who is suffering with a wish to help them.
And again, the individuals in the compassion training
condition actually report significantly more willingness,
or interest in want to approach and to help, compared to
the subjects in the cognitive reappraisal conditioning.
Now when we look at what's happening in the brain,
sure enough, that same part of the brain that
I talked to you about earlier, it's the insula,
shows a significant difference between these conditions.
If you look at the compassion training condition
versus the cognitive reappraisal condition,
there's a huge difference in the activation of the insula
when they are generating compassion.
Another scale that we used comes from scales of well-being,
developed by my colleague here at the Institute on Aging,
Carol Riff. Two of the items from this
particular subscale are, when I look at the story
of my life, I am pleased with how things have turned out.
And in general, I feel confident and positive about myself.
Well, it turns out that the magnitude of activation
in the insula when the person
is doing the compassion practice significantly predicts
the participant's reports of well-being
on this self-acceptance scale. The more activation
they show in the insula, the greater the levels
of well-being. Now one of the unusual things
we did in this study is this. We paid people for their
participation in this study. They actually got $165 if
they completed the whole study. And these actually were students
that were the participants in this study.
So $165 was a pretty nice sum of money.
At the end of the experiment, we gave them an opportunity
to actually donate some portion of the $165
we gave them to any charitable cause
of their choosing. And this was not deception
at all. This was real money.
They were doing real donations. So this was all
completely straightforward. They actually executed the
transaction in the laboratory online in the last part
of the experiment. So we asked the question
whether changes in the brain that we measure,
particularly in this same area, actually relate to
the amount of money that the subjects gave.
And it turns out that there's an extremely strong correlation
between activation in the insula and the amount of money
that subjects actually donated to a charitable cause
at the end of the experiment. We found that the subjects
in the compassion group donated more money,
and particularly those that showed the biggest
boost in activation in this brain region
donated the most money after the experiment.
Now another dimension that we have assessed--
And I won't spend much time on it now.
I'll go through these slides quickly in the interests
of leaving time for questions. Is attention--
In the framework of neuroscience,
we can think of meditation as operating
on two major domains. One is emotion, and
specifically positive emotions, like compassion
of the sort that I showed you. The second domain is attention.
So meditation really can be thought of as a training ground
to cultivate more focused attention,
more well regulated attention. This is a quote
from William James, from his two volume tome,
the Principles of Psychology. William James was just
extraordinarily visionary in his understanding
of the importance of attention. And he said here,
"The faculty of voluntarily bringing back
a wandering attention over and over again
is the very root of judgment, character and will.
But no one is compos sui if you have it not.
And an education, which should improve this faculty,
would be the education par excellence.
But it is easier to define this ideal than
to give practical directions for bringing it about."
And I should note that the italics here
are in the original. They're not my italics.
So James really understood the extraordinary value
of cultivating attention. And I'd like to suggest to you
that meditation is the premier method that
we know something about today, which should be exactly
the right set of procedures for educating attention.
Most practitioners and teachers of meditation
I think will tell you that training attention
is really the substrate. It's kind of the basic skill
which is needed for all other kinds of meditation.
It provides the tools for doing other things with meditation.
So it's often the first thing that is cultivated.
We've recently published a series of papers.
One is in long-term practitioners.
And the other is in less well trained practitioners,
but still intensive meditation, which I'll describe in a minute.
But this is from a very recent paper that we just published.
Julie Brefczynski was the first author
who is a post-doc in my lab. This was a study using
functional MRI to interrogate the neurosystems associated
with the tension in long-term practitioners
while they were doing a particular kind of meditation
that involves focusing attention.
I won't, again, bore you with the details.
But there are a range of different areas in the brain
that have been described as underlying different facets
of attention, all of which were significantly changed
in the long-term practitioners, compared to several
different control groups, which we had in this study.
Another study that we also just published in 2007
was a longitudinal study. This kind of evidence
is particularly important. This was a longitudinal study
over the course of three months. And it was done at
a retreat center here in the United States, where
we set up a mobile laboratory. And we assessed people
before and after an intensive three-month meditation retreat,
where participates in this retreat were meditating
for about ten hours a day, for three continuous months
in complete silence. A very intensive practice.
We were specifically looking at a component of attention,
which is considered to be relatively fixed
and unalterable. And what we are looking at
is a phenomenon that is known as the attentional blink.
What the attentional blink is, is described here.
If you are presented with a rapid stream of visual stimuli,
let's say in the simplest case here, letters and numbers.
Most of these are letters and you occasionally get numbers.
They are occurring very, very rapidly.
At the short interval, they're about a third of a second
between each stimulus. So each stimulus, you're getting
three stimuli per second. It's just firing away.
And if the person's task is to report each number
that he or she sees, what you find, which is really
quite startling if you're a subject in the experiment
and actually experience it, you do not perceive
the second number when it follows immediately
an initial number. When it's very closely spaced
in time, you don't see it. It's as if your mind goes blank
or your attention blinks. It was thought to be
a robust property of the nervous system, where
the nervous system is kind of in a refractory period
and you're literally unconscious of the next stimulus.
Well, it turns out that it ain't necessarily so.
If you meditate for intensively in this way,
you become much more aware, moment to moment,
of the broad array of information
in your environment. And you actually alter
your intentional blink, which was thought
not to be possible. So I won't go through
the details of this, but we found very robust evidence
that among these practitioners from before, to the end
of the meditation retreat, they showed a significant
increase in their ability to detect these stimuli.
And another way to say it, they showed an attenuation
of their attentional blink. We found corresponding changes
in their brain. We monitoring their brain
while they were doing this task. And there were important changes
in their brain that underly this change in their capacity
to pay attention. So the last thing
I'll just briefly mention, although I've eluded to it,
I haven't shown you any direct evidence for it yet.
The changes that are occurring in the brain
are connected to the body. Through structures like
the insula, as well as through our endocrine
and our immune systems. Part of the program of research
in which we've been engaged is not just to study
what's happening in the brain, but also to study
how those changes in the brain may be impacting the body.
And in one study that we did, I'll just give you one example.
This comes from a study that was published a few years ago
that we did with employees here in Madison
at the Promega Corporation, where we collaborated with
the UW Division of Integrated Medicine, and specifically
the mindfulness-based stress reduction program
directed by Katherine Bonus. We administered MBSR
to these individuals over the course of two months
and looked at changes in the brain and the body.
And one of the things that we looked at was responses
to influenza vaccine. All the participants
in this study were given an influenza vaccine.
And by taking blood samples at different points
after the vaccine, you can actually get
a quantitative measure of antibody titers
mounted in response to the vaccine.
And what you can see is that participants
in the meditation group actually show significantly
enhanced vaccine response compared to the healthy--
compared to the non-meditating controls.
These differences are of a magnitude where it's likely to
make some clinical difference. So let me just offer
some final reflections and conclusions.
Then we can open it up for questions.
I've shown you that compassion, loving kindness and
other related characteristics are best viewed
as trainable skills. Mental training
to enhance these skills changes the brain and the body.
Finally, the expression of compassion
by a spiritual caregiver can potentially impact a patient,
and not only help the patient cope with adversity,
but to actually change the patient's biology
to change their brain and to change their body
in a way that may be potentially health promoting.
So what you folks do in your roles is not just to be
a source of comfort and understanding,
but through that, to actually literally change the patient's
biology in ways that may be health promoting.
I want to end with, really a remarkable quote
from Albert Einstein. It's one of my favorite quotes.
And it directly pertains to this topic.
It was written by Einstein in a letter to a friend of his
who was asking for some advice. And in that letter,
Einstein said, "A human being is part of a whole,
called by us, 'the universe.' A part limited
in time and space. He experiences himself,
his thoughts and feelings, as something separated
from the rest, a kind of optical delusion
of his consciousness. This delusion
is a kind of prison for us, restricting us
to our personal desires and to affection
for a few persons nearest us. Our task must be
to free ourselves from this prison
by widening our circles of compassion,
to embrace all living creatures and the whole of nature
in its beauty." Let me end
by just expressing my gratitude to the many people in my lab.
This is just those who directly participated
in the studies that I describe who are actually doing
all the work. I just, these days,
am a conductor and cheerleader. And also to
His Holiness himself. Thank you very much.
( applause )