Issue: Why is the practice of mindfulness meditation effective in the treatment of anxiety and stress disorders?
Hypothesis: Mindfulness meditation is an intense workout of neuronal inhibitory circuits. Neuronal inhibitory circuits lose functionality when their inhibitory commands are frequently or severely overruled or ignored (which happens under many circumstances). Exercising the impaired circuits, which is what mindfulness meditation does, sets them back to good shape, and reestablishes their inhibitory role.
This author has presented this theory in two of his books: Hacia el Buda desde occidente (Toward the Buddha from the West), (2007, not available in English), and Inner Harmony through Mindfulness Meditation (2013).
Objective: This document is to awaken interest in the workings of mindfulness meditation within the academic community and to prompt research around the hypothesis here postulated.
Project benefits: As confirmed by several studies, mindfulness meditation is an effective approach in the treatment of behavioral disorders, such as addictions, phobias, depression, anxiety disorders, obsessive-compulsive disorders and posttraumatic stress disorders.[1] However, there is limited knowledge on why or how these successes occur.
The neurological understanding about why mindfulness meditation is indeed an effective treatment of anxiety and stress disorders should increase the general public acceptance of the approach and spread the application of this inexpensive therapy. This acceptance will grow dramatically as doctors and psychologists start prescribing mindfulness meditation to patients as the appropriate way to deal with their disorders. This comprehension together with doctors’ recommendations should also increase the number of people undertaking mindfulness meditation on their own to improve their mental health.
Mindfulness Meditation and Inhibition
Mindfulness meditation: Mindfulness meditation is a mental exercise during which practitioners, with their eyes gently closed, sit in a comfortable position in a quiet environment, adopt a passive attitude and focus attention on certain anchors (mental devices) in order to enhance their faculty of awareness. Whenever meditators notice that their attention is off course, they take it back to the anchor of their choice. The most commonly used anchors or focuses of attention in mindfulness meditation are the breath and the sensations.
Physiologically speaking, mindfulness meditation,essentially an exercise in behavioral inhibition, is an intense workout of neuronal inhibitory circuits. Mindfulness is about doing nothing, except being attentive to the body, the sensations iand the mental states. Meditators sit in a quite enviroment, silent, motionless, eyes closed, minimum noises, no meals during the previous two hours… No mantras, no malas (rosaries), no mandalas (figures), no music or chants, no fragances or essences… Just sitting to observe impartially, with no judgement, what is going on in the whole body which obviously includes the brain.
Following the ‘use it or lose it principle’, neuronal circuits that are neglected or bypassed through our daily life, forgo their healthy control role and become ‘lazy’ or ‘dormant’; eventually, they stop working properly. The persistent practice of mindfulness meditation, which in a sort of neuronal calisthenics that turns them ‘on’ and ‘off’ repeatedly and rigorously, brings them back to normal operation.
Impaired inhibition: Inhibitory mechanisms deteriorate for many reasons (conscious negligence, inattention, catastrophic events, traumas, massive manipulative advertising, unfounded rumors), and natural appetites or normal fears might get out of control. When appetites are carried away, they grow into addictions (I need more food in spite of being full). When fears go wild, they become phobias or irrational fears (that frightening experience will recur). As addictions or phobias grow in intensity or complexity, they might evolve into a broader range of anxiety and stress disorders.
Scientific Support
A number of research findings point out to a close relationship between anxiety and stress disorders, and abnormalities with neuronal inhibition (see Appendix 1).
From a different perspective, another study by Dr. Andrew Newberg with Buddhist monks in deep meditation provides hints of an important role of inhibitory circuits during the deep stages of the practice (see Appendix 2).
What does mindfulness meditation do? Mindfulness meditation retrains inhibitory circuits and gets their functionality back to normal. When this happens, disorders associated with abnormal inhibitory control diminish in intensity. Some other disorders, such as chronic pain and insomnia, also seem connected with ‘lazy’ inhibitory circuits. (Appendix 3 of the book ‘Inner Harmony through Mindfulness Meditation’ describes what meditators do and experience during the exercise of mindfulness meditation.)
Testing the Hypothesis
Assessment of inhibition: There are three different ‘levels’ of attentional control through inhibition: the individual neuron, the neuronal circuit (set of neurons), and behavioral inhibition. The links among these three levels are not clear, in spite of much research in this area. There is no clarity yet on how neuronal inhibition (that is, inhibitory neurons firing to decrease the likelihood that excitatory neurons will fire) relates to neuronal circuit inhibition (that is., inhibitory circuits or loops acting to slow down excitatory circuits or loops). Neither there is there clear understanding on how inhibition at the neuronal and circuit levels relates to behavioral inhibition (suppressing a behavior or response).
The author of this document knows by direct experience the reality of the theory here described. Still its validity must be tested. The number one challenge for such validation is the identification of reliable methods or techniques to assess inhibitory activity. The first candidate approach to meet this challenge (and, at this point, a promising one) is the Stroop test,[2] the procedure most extensively used to assess behavioral inhibition. Dr. Jason Shumake, a neuroscientist at University of Texas, Austin, and Dr. Cheryl Browne, a psychologist, recommended the use of this tool in this project after a detailed review of this hypothesis in late 2010.
Thanks to the application of the Stroop test in numerous studies, the academic world knows that behavioral inhibition deficiencies are associated with a number of disorders.
A potential supplementary technique to ‘measure’ inhibition is transcranial magnetic stimulation (TMS), a noninvasive method that causes depolarization or hyperpolarization in brain’s neurons.TMS has “the ability to index cortical inhibition by stimulating the motor cortex and measuring the resulting peripheral motor evoked potentials with electromyography.”[3] The identification of the tool to assess inhibition (Stroop test, TMS or other approach) in this research work is an early task to complete early in the project.
The test process: If the theory suggested in this study proves correct, the practice of mindfulness meditation should lead to improvements in the inhibitory control of participant subjects. The experimental part of the project tests the proposed hypothesis.
Scenarios of the Test Process
| Base line | After meditation session | |||
| Subject | Description | Subject | Description | |
| 1 | New student (no previous or limited meditation experience) with meditation training prior to starting actual tests
|
Inhibition is assessed at rest
|
Same subject
|
Inhibition is assessed right after meditation session |
| 2 | New student (no previous or minimum meditation experience) with meditation training prior to starting actual tests
|
Inhibition is assessed right after the meditation session
|
Very experienced meditator (several thousand hours of meditation)
|
Inhibition is assessed right after meditation session
|
|
3
|
Very experienced meditator (several thousand hours of meditation)
|
Inhibition is assessed at rest
|
Same subject
|
Inhibition is assessed right after meditation session
|
The effect of mindfulness meditation could be appraised in three scenarios, as shown in the table below. These three scenarios correspond to the application of the Stroop test, which measures behavioral inhibition. If a tool such as TMS (or another one not yet considered) is used, neuronal inhibition might be assessed. Though the sequence of the testing routines would be similar, the possibility of determining inhibition in real time is very interesting.
What is next? Once some research center develops interest in this project, this preliminary proposal should be reviewed in detail with the interested parties to validate its soundness and potential. This author would make a formal presentation of its contents with recycling and adjustments as needed. If the project gets a green light, the faculty chosen leaders will formally undertake and initiate a research project, and follow the center’s standard methodology.
Author Information
Bio: Gustavo Estrada graduated in chemical engineering at the National University of Bogota (Colombia) and the Chalmers University of Technology in Gothenburg (Sweden). In parallel to his professional career as director of business projects and consultant in information technology, Gustavo has been a dedicated student of Eastern philosophy and evolutionary science, and has practiced meditation and yoga for more for more than three decades. He has published two books in Spanish and one in English. The titles in Spanish are La riqueza de la información: Generación de capital intellectual mediante la tecnología de información (The Wealth of Information: Generation of Intellectual Capital through Information Technology) (1998) and Hacia el Buda desde el occidente: Sus enseñanzas sin mitos ni misterios (Toward the Buddha from the West: His Teachings without Myths or Mysteries) (2007). His most recent book, the one in English, is Inner Harmony through Mindfulness Meditation (2013). Gustavo also has a bilingual website[4] and several blogs. Since the early nineties, Gustavo has written for El Tiempo, the Colombian largest newspaper, as well as for other Latin American media. Mr. Estrada currently lives in Atlanta, Georgia.
Role: This author may certainly participate and contribute to the research project in some activities such as: (1) Making formal presentations of the proposed hypothesis to any audience that develops interest on the subject. (2) Sharing his meditation experience and advising research participants on issues related with the practice of mindfulness meditation.
Appendix 1 – Disorders and Inhibition Dysfunctions
Two independent sets of studies point to a clear relationship between anxiety and stress disorders, and neuronal inhibition dysfunctions. This association is straightforward in the first set, and indirect—through the backdoor—in the second one.
The first three studies—on obsessive compulsive disorders, insomnia, and chronic pain—detected impaired neuronal inhibition in the subjects affected by such problems. In the next three reports—on alcoholism, marijuana addiction and kleptomania—drugs with proven inhibitory effect have lead to positive results in the treatment of these addictive behaviors. With some adjustments or additions, the six descriptions that follow are ‘copied’ from texts in the referenced websites.
Impaired neuronal inhibition
Obsessive-compulsive Disorders: Decreased neuronal inhibition in cerebral cortex has been assessed in subjects with obsessive-compulsive disorders thanks to transcranial magnetic stimulation (TMS),[5] the noninvasive method mentioned before.
Chronic pain: Both chemical compounds and neuronal circuits may be altered in chronic-pain sufferers. Impaired cortical inhibition is one mechanism that is associated with chronic pain. Retraining the brain has the added advantage of exploiting a part of the pain pathway that so far has not been targeted much by drug makers: its inhibitory arm. While painkilling drugs attempt to dampen already activated pain signals, says Dr. Sean Mackey, a pain management expert at Stanford, retraining the brain involves “trying to beef up the muscles that turn down the overall pain experience”, that is, the inhibitory neuronal circuits.[6]
Insomnia: Insomniacs cannot block sounds during sleep. People who dozed through the loudest noises were those whose brains recorded the most “sleep spindles” on an EEG. Scientists say the spindles, produced by activity in the thalamus (a region deep in the brain that processes incoming stimuli), can be used as a measure of how well the brain blocks out sound during sleep. Someday, they say, they may be able to manipulate spindle activity to help light sleepers to have peaceful dreams.[7]
Positive results in treating addictions with inhibitory drugs
Alcoholism: Acamprosate, a drug used for alcohol dependence, is thought to stabilize the chemical balance in the brain that would otherwise be disrupted by alcoholism, possibly by blocking glutamatergic N-methyl-D-aspartate receptors, while gamma-aminobutyric acid (GABA) type A receptors are activated.[8]
Marijuana addiction: Some results suggest that COMT-inhibitor drugs may potentially play a significant role in treating marijuana.[9]
Kleptomania: Naltrexone, an anti-addiction medicine, has been tested and confirmed as an effective substance in the reduction of the urge to steal in kleptomaniacs, according to a study from the University of Minnesota. Kleptomania is a rare psychiatric disorder characterized by recurrent stealing.
Appendix 2 – Meditation and Brain Activity
Dr. Andrew Newberg, a radiologist at the University of Pennsylvania when this study took place, used single photon emission computed tomography (SPECT), a brain imaging technology, to get pictures of several Buddhist monks’ brains.[10] The researcher obtained images that display the neuronal activity throughout their brains both at rest (doing nothing, the baseline) and during deep meditation. The more blood flow to an area in the brain, the more active the neurons in that area are, that is, the more intensively ‘colored’ are those regions in the images.
The pictures obtained by Dr. Newberg studies show that the front part of the brain, which is usually involved in concentration demanding tasks, is more active during meditation. Since meditation is an inaction or stop-doing-things routine—the less the meditator does, the deeper the practice, this author theorizes that the increased neuronal activity displayed by the images must come from inhibitory circuits, as opposed to excitatory ones.[11]
[1] A search in the web of these disorders and the expression ‘mindfulness meditation’ produces dozens of entries.
[2] The Stroop test is used in neuropsychological evaluations to measure mental vitality and flexibility, since performing well requires strong inhibition capability. An increased interference effect is found in disorders such as attention-deficit hyperactivity disorder, addictions and depression. http://sharpbrains.com/blog/2006/10/24/stroop-test-inhibition-and-brain-based-coaching/
[3] Barr, M. S.; Farzan F.; Davis, K. D.; Fitzgerald P. B.; Daskalakis Z. J.: Measuring GABAergic inhibitory activity with TMS-EEG and its potential clinical application for chronic pain. http://www.ncbi.nlm.nih.gov/pubmed/22744222
[4] http://innerpeace.sharepoint.com
[5] Greenberg, Benjamin; Ziemann, Ulf; Harmon, Ann; Murphy, Dennis L, and Wassermann, Eric M. “Decreased neuronal inhibition in cerebral cortex in obsessive compulsive disorder on transcranial magnetic stimulation”: The Lancet, September 12, 1998. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)60009-8/fulltext
[6] Park, Alice. “Healing the Hurt,” Time Magazine, March 04, 2011.
http://www.time.com/time/magazine/article/0,9171,2055174,00.html#ixzz2bDwp0usp
[7] Park, Alice. “Lab Report: Health, Science and Medicine”, Time Magazine, August 23, 2010. http://www.time.com/time/magazine/article/0,9171,2010178,00.html#ixzz1Cuygb2vo
[8] Acamprosate: Genelabs Technologies inc. http://www.genelabs.com/drugsdb/details/acamprosate/
[9] Busko, Marlene. “COMT Inhibitor Shows Promise in Treating Marijuana Addiction”: Medscape Medical News, December 08, 2008. http://www.medscape.com/viewarticle/584904
[10] The type of meditation used by Buddhist monks in this study was a technique called ‘compassion meditation’, not mindfulness meditation. However, this author considers that neuronal activity should be similar in both modalities.
[11] Newberg, Andrew, MD: The Effect of Meditation on the Brain activity in Tibetan Meditators. http://www.andrewnewberg.com/research.asp