Hello and welcome to the new psychology of Depression.
A series of programmes with me, Dr. Danny Pennyman and Professor Mark Williams of Oxford University.
In the previous programme, we looked at the effectiveness of mindfulness based cognitive therapy.
And in this programme, we're going to look at the impact mindfulness has on the brain.
Mark,
one of the most interesting things I think about mindfulness is the impact it has in real time on the brain through various brain imaging studies.
Can you describe those for us? You know, there's now been a number of studies.
One of the things about mindfulness is it came on the scene as a secular practise and as a way of dealing with stress
and depression at the same time that our ability to look right into the brain as people were actually thinking,
doing task for someone opened up as well. So there's something called functional magnetic resonance imaging.
And what that does is to effectively look at what changes are happening in real time in the brain as you're doing tasks.
There's also structural MRI, which can take a very accurate picture of the structure of the brain.
So both of these have led to important discoveries. For the first thing, if you just look at the structural work on the brain,
something called Sarah Lazaar in America has done some fascinating work showing that long term meditators,
people who were meditating for maybe 10 years, show structural differences in the brain.
In one sense, it's not surprising that learning a skill changes the brain.
After all, if you learn juggling, if you learn to play the piano, there's going to be long term changes in the brain.
That's why you can sit down after 10 years of learning the piano and play it.
It's going to be different and that different has to be encoded in the brain. What's different about this is that playing the piano or in juggling,
you're actually doing something with your hands in relation to the outside world.
You'd expect changes in the brain that once they're Eleazar found was that mental training, that is this meditating,
mindful meditation in which you sit on a chair and just notice your mind wandering and bring it back.
Now, did your mind wander the big bang that that itself? If you do that for a few years, actually changes the brain.
Now, the question is, what it change? One of the most interesting parts of the brain that it changes is the part of the brain called the insula.
Now, other research shows the insula is like a sort of a junction of body sensations.
It switches on when you have any strong body sensations, but it also has links.
It links together sensations from the surface of the body, sensations from the inside the body, the viscera.
For example, you know what your tummy does when it flips over, but also has projections to the cortical other areas of the neocortex.
The frontal part of the brain. So it's a bit of a junction.
And people have found, for example, that the insula lights up when you're doing a task that demands empathy.
When you see somebody else in pain, a loved one in pain, then the insula lights up.
And if it doesn't light up, then you don't feel empathy.
So the fact that you get long term changes in this part of the cortical surface of the brain is, I think, extremely important.
Some people have said this is a very important part of the brain for I'll be able to to feel the feelings of other people,
to have compassion for other people, to have kindness towards other people.
Now, this is not just kind of towards the people.
It's actually kindness towards yourself as well, because in depression and many other mental health problems,
people feel very unkind towards themselves, very unkind. They are their own worst critic.
Therefore, the ability to cultivate kindness and compassion is really important.
Does it take 10 years or do the positive effects begin to kick in after, know, a few days or a few weeks?
This is one of the fascinating things. Norman Farb,
working in Toronto with Adam Anderson and Zindel Siecle have done research on just eight weeks of mindfulness
training using an MBA star programme in which people come in and do the do the programme for eight weeks.
But they look at them either before or after. And what they find is something really interesting.
First of all, it involves the insula as well. If you get people to focus on their body, for example, it never done mindfulness before.
What tends to happen and you can see it in the brain is that not only do they
focus on their body or on the experience of something in moment to moment,
but they start to think about stuff. In other words, it spreads to thoughts, memories, a lot of thinking about the self and so on.
And you see this part of the brain involved in self processing lighting up as well.
Now, when you learn mindfulness, you learn to focus on the body and you learn to stay with the experience of sadness or anxiety or
irritability and stay with that through the body sensations without it creating a story about things and.
In their studies, they find that that's exactly what they can see in the brain.
After eight weeks, you see that the insula can light up as people are able to focus on the experience,
on the raw experience, having an emotion, for example. But then it's uncoupled from those parts of the brain that are, as it were telling you,
a story about or thinking about stuff we know from lots of other laboratory experiments.
This ability to experience things without thinking about them turns out to be really important,
because a lot of the problem in depression, in worrying anxiety in eating disorders is overthinking.
You think too much about things and you take a problem and actually make it worse by thinking too much.
The fact that you can see in the brain these things getting uncoupled is, I think, really, really hopeful.
We've got a biological marker, as it were, of this experience.
Be able to deal more wisely with things rather than just always overthinking and problem solving about.
But what does this mean in the real world? Does it mean, for example, we come off the hair trigger, which means if we find our path blocked,
we react less angrily or with less anxiety or with less stress.
So we've known for years that the fight and flight mechanism is a very evolutionary old system.
If you see the ear of a tiger, you don't want to be playing around anymore.
You need to freeze. And then when it's safe to do so, you make a dash to safety.
And this is very automatic. It's very old. It preserves your life in dangerous situations.
Now, part of this system is what's called the amygdala. It's deep in the brain.
It responds to anything that's highly arousing and most particularly to fearful situations in which you need to take direct action.
In fact, we know that from Joseph Ledoux's work, that this amygdala, when you see something looks like a snake,
there's a pathway that goes straight from the eyes to the thalamus to the amygdala.
And that does that before you even started to think you started to react before you can actually think about what you're doing.
What's interesting is the amygdala was designed to deal with real threats in the outside world, but human beings have evolved.
Another extraordinary capacity, and that's the capacity to have language and to have inner language.
We can think. We can imagine and we can bring back memories from a long time ago,
or we can create an image of something that might happen next week, might happen next year.
And it's almost as if, having created or simulated these events in the mind's eye, as it were, then the amygdala reacts as if it was a tiger for real.
Now nobody can run fast enough to get away from their own imagination because the imagination goes with them.
Nobody can run fast enough to get away from their own. So imagine fears.
And yet the amygdala doesn't know that, you know.
So what happens is that if you look at gazelles, for example, in the African savannah being chased by a leopard or a lion, they run like crazy.
But when the lion is dragged one gazelle off or is given up the chase for the day, the gazelles go back to grazing.
They have to graze to live. And the fact that they're grazing quite calmly five minutes later shows that their amygdala,
which was going crazy five minutes ago, has now gone back to normal.
They've switched on the fighting flight when they needed it. But more importantly, they've switched it off when they don't need it anymore.
In humans, we can switch on. But because of our imagination and our memory and our worries for the future,
which we can bring up right now, unlike the gazelles, we don't switch off the amygdala.
And now is that true in neuroscience? It turns out to be wonderfully true in an extraordinary way.
So David Cresswell working in the United States, has put people into the scanner who are known to vary in how mindful they naturally are.
So some people are very mindful. They notice things in the environment.
They taste their food. They don't rush around so much.
But other people in the scanner, they're the sort of people that are always rushing from one task to the other to keep up.
They're always there. They never taste their food. They never notice where they are.
Guess what happens in the scanner?
It looks very much from his work, as if people who rush around all the time, who are mindless, their amygdala is chronically overactive.
It's like the amygdala is stuck on the on position. They're the gazelles that don't stop running.
And so lots of people who rush from task to task in their daily thinking they're being creative is just an illusion of creative productivity.
It's actually as far as their brain is concerned.
They're running away from something that has very pervasive effect because it going to affect how you process a lot of other information.
In effect, you're saying that mindfulness is powerful enough to alter even the most deep seated.
Primitive or most parts of our brain? Absolutely. We've mentioned the insula.
That's part of the cortex. But we've mentioned the amygdala, which is part of the more ancient emotion system of the brain.
But there are sort of intermediate things. There's something called the dorsal anterior cingulate cortex.
We know that that switches on or responds if you feel as though we're either in pain or social pain.
So let's say that, you know, you are part of a threesome throwing a ball to each other.
And suddenly the two people you were playing with started throwing the ball to each other and they missed you out.
You start if you were you know,
now you can do an experiment in which you put people in a scanner and you pretend you're playing a game with them and they're part of a game,
a threesome at a ball tossing gain on the computer.
And then you start making the game actually deliberately look as if you're being excluded.
If these other two people are playing with each other and not with you.
And what you find is the dorsal anterior thing, the cortex actually begins to respond to this as if you are in pain.
It's like a social. You're feeling socially excluded.
And some research now from the states, again, finds that people who are high on trait mindfulness have much less effect.
They don't feel so socially excluded. They're able to sort of take a step back from that.
But people who are more in this rushing around mode all the time,
who are frantically rushing rental against your there are much more sensitive to this.
They actually feel excluded, a drop of a hat. They're on this hair trigger not just for a tiger, but for feeling actually in the outgroup as well.
So it's not surprising that they're spending a lot of the time trying to trying to find a way
into the ingroup because they're so sensitive to these little signs of social exclusion.
And there's not just real social exclusion. This is imagine social exclusion.
Again, in the real world, if we tamp down on the negative pathways of the brain and they enhance the so-called positive pathways of the brain,
does that enhance creativity and productivity and as well as self-esteem and general levels of happiness?
Absolutely. So there's a study now in the Netherlands that have looked at people going through an empathy programme.
They find that it reduces negative affect, but it also increases wellbeing.
The reduction in negative affect flows from the ability, the greater ability people learn to let go of nasty things from their past.
So they don't ruminate and dwell on them. The increase in well-being actually doesn't so much relate to that as the ability to really notice.
Day to day, moment to moment, living, tasting things they've, as we've forgotten to taste, begin to see small things like flowers, trees.
The smile of a child, which you'd normally just ignore. It doesn't take more effort to notice these.
You just need to notice that you're not noticing them. That's enough.
Then, as it were. Wake up. So this increase in well-being is extremely important.
But there's something else goes on as well. Some other brain studies done, first of all, by Richard Davidson in Wisconsin, in America.
And we've replicated his work here in Oxford. Looks not at Fmr AI studies.
The imaging the brain through that, but uses EEG. That's the electro Ancef, the graph.
Those take measures from the surface of the brain. And it looks at the electoral activity that goes on all the time.
The humming, buzzing sort of thing that goes on normally the brain what Richard Davidson found was really interesting,
that people who were always avoiding things, who didn't like what was going on in their mind or going on around them.
The brain gets into a pattern in which the right side at the frontal air of the brain is more active than the left.
And if you show somebody a nasty photograph, then that's what will happen to all of us.
The right side will go right on the left. However, if you show somebody a photograph of a smiling child, suddenly you find it switches.
The left is now more active than the right. For years we thought that was a sort of a set point that you couldn't change.
It was a personality characteristic.
What Davidson showed with John Cabot, Zen and others, was that through doing an eight week mindfulness course and BSR course, you could switch this.
So it was more likely to be more activation on the left, the right, more into this approach mode than the avoidance mode.
What's more, a few months later, people had maintained this neural pattern.
And the more that they maintained it, even in the face of sadness,
because they also used the Prokofiev and found that normally when people listen to that, the brain's signature shifts more to the left.
But in this case, they are able to maintain that sense of being open and willing to experience their emotions.
And what's more, those who were most able to do that were able to show differences in their immune system.
So their response to an influenza jab, for example, showed that their immune system, the state of their body, was in a more healthy state.
So how long each day do you need to meditate to gain all these benefits? Well, I think people need to try to.
Themselves. There's no prescription, there's no prescription in our clinic.
People do 40 minutes a day. People who've been seriously depressed for for many years, they start at the very first day.
Day one, they start with 40 or 50 minutes a day and then carry on doing that six days a week for eight weeks.
If people don't have serious clinical problems, then they may find shorter meditations more useful.
And as you know, in their funding world book, we offer people something and one minute we offer them a three minute.
But the standard meditation for the first week is eight minutes to be done twice a day.
And what that allows people to do is not just to get used to long meditations, but to the transition from not meditating to meditation here.
People, if you want to get up in the morning. That's the most difficult thing to do.
Get up and meditate or stop the tele television and go meditate or make that transition into meditation.
So what we've done in our book is to use shorter, more frequent meditations where it's more likely that people who have to fit them into their life.
Then when they get there, then they can decide how long to stay there. Okay.
How little can I get away with? I think the attitude of going for is how much do you need to do to discover what needs to be discovered?
Because meditation is a training programme in which you start to find or discover that you get insights into the
patterns of mind that are getting you into sort of entangled in your day to day life and your relationships and so on.
As you meditate more on a daily basis, you begin to discover more so that the invitation is to meditate as frequently
and for long enough that you begin to want to do it on the basis you say,
what are we going to discover today? Not how little can I get away with?
Because that's the sort of that is the activating the avoidance mode of the mind.
And therefore, we know the voids. The mode actually sets up a rather narrowing, constricted view.
An interesting experiment was done some years ago in which this illustrates these different approaches to life in general.
For example, what this experiment did is called the Mouse in the Maze Experiment, and they had students do a series of simple paper and pencil tests.
The first one was to help a little mouse get out of a maze, you know, get home safely.
The second one was one of those creativity tests. How many uses can you think of for a brick?
And then somebody analyses them to look. How creative are they? I mean, for example, if you just say build a wall, it's not terribly creative.
But one person came up with all pounding down to dust, add water and use it for face paints.
Well, that's slightly more creative. So you can you can use that as a source of creativity test.
Well, here the students were doing this creativity test.
But first of all, they did this help this mouse get out of a maze, out of this labyrinth, unbeknown to students.
There were two versions of this maze. So they all had to put their pencil on and get the mouse out of the maze.
It took about two minutes. They all did it successfully.
But in one version of this cartoon maze, the little mouse, just before he got out and got to his mousehole on the on this picture,
there was a lump of cheese waiting for him to feast on before he went to bed.
In the other the other half, the students had no no cheese.
But there was a picture of an owl floating overhead ready to swoop down and catch the mouse in its talons at any moment.
So here were these groups of students, some of them getting the mouse out of the maze with that paper,
with their pencil on the paper and in the corner of their eye, there was cheese.
The other students in the corner of their eye was an owl. Now, all the students did the maze perfectly well in a couple of minutes.
But the students who'd done this, two minutes on the maze with the owl in the corner of their eyes, they did it.
They were 50 percent less creative on the creativity task.
It's astonishing, isn't it? It's amazing. It was published in one big psychology journals a few years ago.
And not only did it affect that effect, people's memory as well. People were more cautious.
And when you think about it, it makes sense. We have evolved to look out for predators.
And millions of years ago, we needed to look out for predators. And when you see a predator, you don't get playful.
You don't get creative. You basically like a rabbit to a rabbit hole.
You want the tunnel vision to lead you from here to your rabbit hole. You don't look either way.
What we now know is that, of course, when people are in avoidance mode all the time, then it's a problem.
So that affects meditation as well. If people are sick, how little can I get away with then?
Of course, it's a very legitimate question to ask. But there's just the danger that actually that's avoidance mode.
So one of the things in meditation is just a notice that to say, ah, listen to that thought.
That's probably avoidance mode turning up. Just smile at yourself.
There's no need to give yourself a harsh judgement. Just smile itself saying, hey, my mind's.
Seeming to be in a frantic mode. So this illustrates why I need to get on my cushion or my studio, my chair,
and do a few minutes of meditation in which you recognise these patterns of the mind,
like weather patterns moving across the landscape and begin to learn to smile at them.
This is clearly a rapidly evolving area. Over the next five, 10, 20 years, how do you expect it to pad out?
One of the things that we've learnt is this tunnel vision doesn't just affect, you know, your attention.
It affects things like suicidal depression as well.
We now know from our research in Oxford that when people have been suicidal in the past, if they get a little bit of sad mood,
unlike anybody else who's been depressed, even depressed many times, if they've been depressed and suicidal.
This tunnel vision doesn't just affect what they see. It affects what problems they come up with.
We need more research to notice how those signatures of suicidal depression can be avoided.
Our research is beginning to show that some people naturally come up with mindful statements there to help them through.
Other people don't. And we need to know how we can best help them.
The other thing is that we want to prevent the very first depression.
So we're working closely with mindfulness in schools dot org, which is a school's mindfulness programme.
That's the U.K. version. But there are many programmes in the United States and all over the world actually teaching meditation to schoolchildren.
It turns out they love it. They can do it really well with a good teacher who knows about mindfulness, who's got a mindfulness practise.
It doesn't take very much for children to go, wow, this is amazing.
So introducing into schools is really important. But we can go even earlier than that.
We know that couples expecting a baby respond very well to being taught mindfulness.
It helps them deal with the fear of childbirth. It helps them deal with the pain of childbirth.
And what's more, the evidence,
early evidence suggests that it helps the bonding of the couples together through this difficult time can be very difficult for some couples,
but also the bonding with the infant, with the new baby. There's critical dance that's done between a baby and their parents.
And often if the parents are depressed, preoccupied mum or dad, then they don't do this delicate dance.
This meshing with their baby. And we know that has long term consequences for for the developing child.
So teaching people to attend is hugely important.
It's the work that Nancy Bartok, he started in California. And we hope to start a European initiative based on her work here based in Oxford.
Wade, should people begin meditating then? Is it suitable for five year olds?
10 tenure? It can be five, six year olds. There's no problem. Just short meditation.
I mean, you can teach a child to focus on the soles of the feet, for example. You can teach a child to find a place.
Are still quiet space within them. Interestingly, you don't have to very long.
Children get it very, very quickly. Of course, the brain is developing.
You don't have to do very much. Most of us who are adults, we've trained in the thinking analytic mind.
We've never trained to actually notice our own bodies, to notice our experience, to notice what's going on in our minds.
Children take that very well. That's really surprising because I certainly when I was a child, I lived in a dream world.
I loved it. I wouldn't change a thing. But I can't imagine at that age I would have taken to mindfulness meditation.
Well, if it enabled you to ground yourself so that you could take advantage of your dream world, that you might have enjoyed it even more.
Because mindfulness is not just about stopping your daydreams. It's about choosing.
It's about allowing you to daydream if you want to. And if there are troubles around, it's allowing you to address those skilfully as well.
And that's what the children actually seem to get out of it. So in some of the work done in Oxford by my colleagues,
Dina Leavelle and Sarah Hennelly and by the Mindfulness in Schools programme, they discover, for example,
15 year old girls who are feeling rather phobic of school, who hate their lessons,
who aren't able to concentrate, to stay awake at night, beginning to find ways that they can manage that better.
And that teaches the girls and boys themselves and their parents notice the difference very quickly.
Now, this is all rapidly developing work. We need better trials to do this.
But when people reach adulthood, there's still lots of questions we need to ask.
We know that people who have bipolar disorder, for example,
which is a very serious that used to be called manic depression, very serious problem for many people.
People take to mindfulness very well.
But there now needs to be trials to say, well, does it actually prevent new episodes of mania or new episodes, depression?
And of course, the brain science itself is helping us know how mindfulness has its effects, how it affects different types of depression,
and also which practises within mindfulness are best for whom we have a whole range of practises.
And at the moment, people trialled all these practises and they discover which is best for them.
But I think the advance in brain science are beginning to show what is the best practise for people perhaps who ruminate and brood a lot?
What's the best practise for people who are very avoidant? How can we give people different gateways in.
The same sort of open spaciousness of awareness that can be shown in their brain and in their lives.
I'm sure there's plenty of people who are listening to this programme would would love to help in some ways.
Is there any way that they can? Well, indeed.
If they want more details, of course, they can go to the Frantic World dot com website or to reading the book Mindfulness.
Finding Peace in a Frantic World. But also, there's been a book specifically written for people depressed, depressed,
the mindful way through depression by myself and John Teesdale and Zengel Seagle and John Cabot Zen.
And also, because there's so much research to be done in the future,
we're beginning to get a development campaign together at Oxford Mindfulness Centre.
As part of the university's Oxford Thinking campaign to fund a professorship in mind and science that we able to take this forward in the future.
Over the eight hundred years of Oxford University, sometimes hundreds of years ago,
people who wanted to make a difference making a permanent difference in the world did so by investing in endowments for the university.
So they knew that even in decades or hundreds of years time, no matter how much the field had changed,
there'd be somebody there working right on the forefront of it. And who knows where this field will be in 10, 20, 30, 40 years time.
But by raising the endowment for a new professorship of Mines and Science to work on this,
we know that wherever the field is, somebody will be working on the forefront in the future.
And if anybody wants to help, of course, they can go to Oxford mindfulness dot org or through the university's own website and discover the
development campaign that we're putting together as part of Oxford University's contribution to this field.
The mind is one of the most fascinating things that anybody could research. But when it goes wrong, it's one of the most tragic things to see.
I think that certainly the 35 years that I've been working in the field of depression on the psychological treatment of depression,
I've seen many changes. I can't anticipate where we'll be in another 35 years.
I may not be around to see it, but I think committing ourselves now to saying this work is really important.
And wherever we got, there's going to be people that need more treatments, more effective treatments, both to prevent depression and prevent suicide.
That's what I think we need to be committed to, and that's what I'd like to see happen over the next few years.
Well, it really could change the world. Which is ironic for a teaching that is two and a half thousand years old.
Thank you very much again.