Meditation is a mind-body practice that focuses on the interaction between the brain, mind, body and behaviour. I see meditation as a tool for awareness and focus, Psychotherapy as a tool of actively changing perception and Buddhism as a holistic guide. I love that this is a seemingly perfect example of where ancient practices meet modern medicine and as such, this article will investigate the interplay between these disciplines.
Perception and the Status Quo
Sometimes I picture the mind as akin to a computer programme, whereby a lot of the wiring and base code is constructed during childhood and lays the foundations for the unconscious seabed of our adult brains. It seems strange that looking back at the dusted and dated photographs of our childhood selves, we automatically discern such beings in the third person, unable to relate to this fundamental yet vague memory of ourselves any longer.
The wiring we mature with is incredibly difficult and uncomfortable to change. We are often unaware of just how much it shapes the way in which we individually interpret the constant stream of sensory data inputting itself into our neurons. A simple example is our perception of time and the concept of the past and future. Most of us automatically visualise the past to be behind us and the future to be in front, confirmed by the arm gestures made when vocalising the subject. Conversely, the Aymara people from the Andean region of South America, view the past to be in front and the future to be behind them. What initially seems absurd because of our autonomic preconceptions, can eventually be explained in an entirely convincing manner. The past is the only thing that is known, therefore it is what we see. The future is unknown and therefore remains hidden from view behind us. The Aymara move backwards through the uncertainty of life. It is only when events have happened that they bring themselves into clear view and shape our vision of the current situation.
Perhaps things are clearer in foresight, as opposed to hindsight after all. Challenging the way we think, even with regards to the most basic things, is uncomfortable and difficult. It takes self-awareness, practice and guidance: 3 key things that may sound synonymous with mindfulness and meditation.
Before I committed to regular practice, I had to know that it was worth my time and see if the evidence spoke for itself. A few studies have shown that Meditation can reduce the density of brain tissue associated with anxiety and worrying, which aids in lessening the effects of the western world’s primary killer – stress. Regular meditation could also improve cognition and increase your ability to perform tasks requiring focus. Some specific conditions that have seen benefits from meditation include high blood pressure, IBS, smoking, Ulcerative Colitis, Pain, Anxiety, Depression and Insomnia amongst others. It is recommended that meditation is used as part of a holistic approach to treating such conditions and is therefore practiced alongside medical therapy, as opposed to replacing it. You can read more about the scientific benefits of mediation on this website which has neatly compiled a few studies and infographics.
There are many different kinds of meditation. Compassion meditation for example (also known as Metta), has been shown to enhance brain areas associated with mental processing and empathy. Most of these varieties share four common elements : a quiet location, a comfortable posture (sitting, lying, walking), a focus of attention (a word, an object, the breath) and an open attitude (observant and non-judgemental).
Why and How is this the case? What are the mechanisms behind the benefits?
Knowing that it seems to work is not enough, the question is – how? Well as with most complex areas of neuroscience, the jury is still out on this one. Using equipment such as fMRI and EEG, researchers can directly observe brain physiology and neural activity before, during and after meditation, thereby establishing links between regular practice and changes in brain structure or function.
The medial prefrontal and posterior cingulate cortices have been found to be relatively deactivated during meditation. Conversely increased activity in these areas of the brain have previously been linked to worsening major depression, which may be linked to the symptom of rumination of negative memories. In addition, experienced meditators were found to have stronger coupling between the posterior cingulate, dorsal anterior cingulate and dorsolateral prefrontal cortices, both when meditating and not meditating. This could be linked to the effects of improved cognition and focus and shows that regular practice provides long term benefits.
Are there any side effects?
Anything that actually works is not without its side effects and the same applies to the ironies of meditating, as a greater awareness about oneself can be a double-edged sword. Heightened awareness can sometimes perpetuate self consciousness, which may heighten anxiety, especially if you are already that way inclined.
This is why I feel it is important to marry meditation with psychotherapy. I personally enlisted the coaching of my friend Jay, who recently left a career in financial services to pursue her therapeutic passions. She explored the thought patterns around negative self-esteem and took a genuine and empathetic approach to ‘re-wiring’ these, in a manner similar to cognitive behavioural therapy. Simple recommendations around better sleep hygiene also went a long way – no laptops or phones at least an hour before bed and cutting caffeine after 12pm.
The NIH advises prospective meditators to “ask about the training and experience of the meditation instructor…[they] are considering”, as with any practitioner. It should not be used to avoid facing ongoing problems – applying mindful practices here would be more useful. It is also not a replacement for conventional healthcare or a means of postponing seeking medical help.
Meditation still has its critics and scientists such as Owen Flanagan phD dispute that the scientific claims have been overly exaggerated. Flanagan’s book Bodhisattva’s Brain: Buddhism Neutralised illustrates his view that the current literature does not support the idea that positive emotion can be strengthened in the same way that stroke victims can reclaim the use of their limbs. The mechanisms are still clouded but all figures are in agreement that further research is needed.
Buddhism and Psychotherapy
The four noble truths as preached by Buddha are that life is full of suffering (Duhkha), that there is a cause of this suffering (Duhkha-samudaya), it is possible to stop suffering (Duhkha-nirodha), and there is a way to extinguish suffering altogether (Duhkha-nirodha-marga i.e. Nirvana).
The Eight fold Path (astangika-marga) as advocated by Buddha, serves as a guide and a means of extinguishing the sufferings. It is the last three segments of the path that are most well-known with regards to the practice of mindfulness and meditation. They include:
6. ‘Right effort’ – Taking control of your mind and the contents thereof, making an effort to develop good mental habits. When bad thoughts and impulses arise, they should be abandoned. This is done by watching the thought without attachment, recognising it for what it is and letting it dissipate. Good thoughts and impulses, on the other hand, should be nurtured and enacted.
7. ‘Right mindfulness’ – Mindfulness refers to a kind of meditation (vipassana) involving an acceptance of thoughts and perceptions, a “bare attention” to these events without attachment. It becomes a way of developing a fuller, richer awareness of life.
8. ‘Right concentration’ – One who has successfully guided his life in the life of last seven rules together and thereby freed himself from all passions and evil thoughts is fit to enter into deeper stages of concentration that gradually take him to the goal of his long and arduous journey – the cessation of suffering.
These should be conducted with the first 5 elements of the path which concern wisdom, ethics and morality.
If we look deeply into such ways of life as Buddhism, we do not find either philosophy or religion as these are understood in the West. We find something more nearly resembling psychotherapy – Alan Watts
Buddha was a unique psychotherapist and his methods have helped millions of people throughout the centuries. In fact I think you could see many components of religious and spiritual practices as a means of reframing elements of psychology and neuroscience for the lay person, as you do not have to fully understand every detail of the path in order to take the first few steps along it. This reminds me of the consolation a programmer would give me when I attempted to learn to code, he said it was “like entering a dark tunnel where you can’t see anything but you know there is a light at the end that will eventually make everything clearer. The further along you blindly go, the more your eyes shall adjust to the dark and the better you shall start to be able to see”. You just have to stay motivated in slowly progressing down a difficult path and not resign yourself to a lazy life in the dark.
Although I do not subscribe to any one religion, I think that Buddhist practices seem incredibly introspective and often make rational sense. If you take the definition of sanity, it is to be reasoned and rational in our behaviour, thinking objectively through logic. We are all innately emotional beings and emotions are by nature instinctive, intuitive, subjective and often therefore, irrational. Is it not the case then, that instead of being inherently sane creatures trying to maintain our sanity, we are all inherently on the spectrum of insane and should find sanity in the rational objectiveness of ‘enlightenment’?… Perhaps this is why Buddhism preaches the avoidance of emotional triggers including ‘sensuality’, sometimes I wonder if this is potentially ironic alongside promoting compassion and love.
“The only movement within our culture which partly has, and partly should have, some understanding of these aspirations for such enlightenment is psychotherapy” – Carl Jung
If a large part of our brains is dedicated to the subconscious and we are only aware of the significantly smaller conscious percentage, then how well do we really know ourselves and how much of what we do is actually a ‘free’ decision? I recently went to a performance by the incredible philosopher, psychologist and illusionist Derren Brown, which seemed to visibly illustrate this point. At the end of some of his shows, Brown occasionally reveals some of the subliminal queues he has used throughout the sequence and the way in which these subsequently affect the thoughts and actions of his unsuspecting participants. This is something that the media and advertising industry understand and exploit all to well, often to our detriment.
Silence and Science
There is still a lot of stigma attached to mental health, especially when it comes to seeking formal assistance. The predominant view is that one should be made to wait until the final straw has irreparably broken the camel’s back before seeking such help, yet prevention is always simpler and more effective than cure. If you feel put-off such techniques because you have a fear of being ‘boxed’ or ‘labelled’, then take solace in the key message of a clinical psychiatry rotation – insight is easily one of the most defining features of a good prognosis. It’s the Homo sapiens that claim to be faultless and not in need of a willingness to better themselves that you should be wary of, such people often subscribe themselves to a lifetime of blaming others instead.
If you are low on time and funds, a number of studies have found that online (/ mobile app) mindfulness training does produce results similar to in-person training. I highly recommend Headspace App (unsponsored). It’s well documented that like most of our muscles, our cortex shrinks as we get older. This makes it harder to solve complex problems and recall memories. Increasing your gray matter in this area of the brain through exercises like meditation can only be beneficial during the ageing process. A study conducted by Lazar found that it only takes 8 weeks of an average of 27 minutes a day to visibly see a structural difference.
It’s not just our minds that benefit, mind and body are closely interlinked and maintaining a healthy mind has a trickle down effect, especially with regards to lowering stress. It’s socially acceptable to go to the gym to physically train your body, or enlist the help of a personal trainer to demonstrate how to do this effectively. Why then is it still less common for us to enlist the help of someone who can help us adequately train our minds? I would argue that this is just as important for the population at large, if not more so. Marrying elements of ancient wisdom with current evidence from modern science seems the best method we have of doing so.