In this episode I speak with Jay Sanguinetti, Research Assistant Professor and Director of the NICE Lab (Non-Invasive Cognitive Enhancement Lab) at the University of New Mexico, and Science Director of the SEMA Lab (Sonification Enhanced Mindful Awareness) Associate Director of the Center for Consciousness Studies at the University of Arizona.
Dr. Sanguinetti investigates the use of noninvasive brain stimulation to enhance cognition and well-being. We discuss Jay’s work investigating whether focused ultrasound can be used to augment meditation practice in the development of mindfulness. I found this conversation fascinating as it highlights how modern brain technologies could enhance wellbeing and also because the impact could be significant; while mindfulness is an effective intervention for pain, addiction, and mood disorders, many people don’t persist with mindfulness training long enough to experience the full benefits.
Show Notes
1:13 – What is Jay working on?
4:10 – How does Jay think about enhancing mindfulness?
8:30 – How does Jay measure mindfulness?
13:10 – Do the changes in the foundational attentional constructs tend to be correlated?
17:05 – How does Jay think about particular brain networks involved in mindfulness?
21:43 – Do the targets of brain stimulation change depending on the experience of the practitioner?
24:00 – What is the experience of brain stimulation while meditating like?
26:00 – How does the stimulation enhance people’s ongoing mindfulness practice?
29:05 – What is the meditation-stimulation protocol?
33:00 – What is the experience like for experienced meditators?
39:30 – How are they progressing with bringing the technology out of the lab and into the world?
43:30 – Is the close collaboration with a meditation teacher typical of contemplative neuroscience labs? And what has the experience been like?
46:00 – Jay’s advice for student pursuing similar interest to his.
Shinzen’s meditation system, Unified Mindfulness, and meditation app, Brightmind, which exemplify the style of meditation practice that participants in Jay’s research undergo.
At the SEMA lab, Jay is working on understanding mindfulness, how mindfulness influences the brain, how to measure the impacts of mindfulness on the brain, and how the practice of mindfulness can be accelerated.
At the NICE lab, Jay is looking to use technology to enhance learning and attention.
4:10 – How does Jay think about enhancing mindfulness?
Firstly, defining mindfulness is not straightforward. For the purposes of the lab, Jay defines mindfulness as a state supported by three attentional constructs: concentration (focusing and sustaining one’s attention on stimuli), sensory clarity (tracking moving stimuli) equanimity (being balanced and not prone to being highly reactive). The idea is that these three attentional constructs work together to enable a present centred form of awareness known as mindfulness.
And once these three constructs are measured, and the brain processes that underpin these constructs are identified, brain stimulation is used to enhance each.
8:30 – How does Jay measure mindfulness?
Jay uses a mix of self-report, behavioural tasks and neuroimaging to measure each of the attentional constructs that he considers foundational to mindful awareness.
13:10 – Do the changes in the foundational attentional constructs tend to be correlated?
You can be really good in one or two of the attentional constructs, but you seem to need all three for mindfulness. Equanimity might be the most important of the attentional constructs for mindfulness. Equanimity can be thought of as the stickiness of your mind. High equanimity is when information can just come and go, flowing effortless through your brain without triggering a strong emotional reaction. Low equanimity is when information is ruminated on, causing the brain to get kind of stuck, and triggering strong emotional (or numbing) reactions.
17:05 – How does Jay think about particular brain networks involved in mindfulness?
When you’re beginning to learn to meditate, the attention centres in the brain, such as the anterior cingulate cortex (ACC) become more active. This probably reflects the practice of noticing when your attention wanders off it’s anchor (commonly the breath).
But after a sustained period of practice (months in duration) the noticing process becomes implicit. The monitoring of where your attention is becomes somewhat automatic and the practice becomes about being kind to yourself when you realise that you have failed at the task (and your mind has wandered). That is, the networks that underlie emotion (and the sense of self) are increasingly effected.
21:43 – Do the targets of brain stimulation change depending on the experience of the practitioner?
Yes. You wouldn’t want to induce a profoundly different experience for someone (such as ego-dissolution) if they aren’t going to have the ability to navigate it well.
Jay started with three main targets in experienced meditators: the basal ganglia (key to habit formation), the default mode network (key to narratives about the self) and the anterior cingulate.
24:00 – What is the experience of brain stimulation while meditating like?
Jay’s current protocol aims to disrupt the functioning of the default mode network. People report that the mental commentary and elaboration while meditating is greatly reduced. People often ask when they can come back again!
26:00 – How does the stimulation enhance people’s ongoing mindfulness practice?
By inhibiting the default mode network, the stimulation reduces the mental commentary and elaboration that get in the way of mindfulness, allowing people to have more successful initial attempts at meditation. This initial success is probably important in many ways.
29:05 – What is the meditation-stimulation protocol?
The current protocol is a 2 program in which everyone starts with the same kind of meditation practice, inspired by Shinzen Young’s teachings. Over the course of the 2 months, people receive 4-6 stimulation session. In each stimulation session, people being meditating and then the ultrasound stimulation begins while people are already practicing. Half people get real stimulation and half get placebo stimulation. For the rest of the 2 months, people are practicing meditation without any stimulation.
33:00 – What is the experience like for experienced meditators?
When experienced meditators meditate, they show reduced activity in the default mode network that underlies self-referential cognition. When this is further inhibited by stimulation, people sometimes report having experiences that are similar to the experiences of ego-dissolution commonly reported in psychedelic studies. However, doing this reliably, or being able to induce such experiences in novices is likely difficult and not the focus of current studies.
39:30 – How are they progressing with bringing the technology out of the lab and into the world?
Funding has slowed translation efforts, and most of the pilots Jay has run to day have had ~15 participants. Jay had recently secured significant funding to build a clinical to treat chronic pain and opioid addiction and run 40-60 person studies. However, this all fell through due to the Covid-19 pandemic. Instead, they are doing work stimulating while people are in an fMRI scanner.
43:30 – Is the close collaboration with a meditation teacher typical of contemplative neuroscience labs? And what has the experience been like?
There are pros and cons to the collaboration. A positive is that there is a lot of nuance and debate around mindfulness that you may miss if you don’t collaborate with a meditation scholar and/or teacher. On the other hand, there is the risk that you may be biased by the relationship with the teacher. Balancing these pros and cons is key. One way which Jay tries to do this is to consult with multiple meditation teachers.
46:00 – Jay’s advice for student pursuing similar interest to his.
Firstly, try to figure out how to keep your curiousity alive. Formal education can often kill people’s curiousity. Work out what question is really driving you. At the same time, develop your analytical logic and math. If you are interested in studying mindfulness, Jay thinks that you should have a practice yourself as the object of study has fundamentally to do with changing your experience. Then learn cutting edge methods that will allow you to understand the phenomena on many different scales.
In this episode I speak with Norm Farb, Assistant Professor in the Department of Psychology at the University of Toronto, and Principal Investigator of the Regulatory and Affective Dynamics Lab.
Dr. Farb studies the neuroscience of the self and emotion with a focus on how cognitive biases shape the emotional reactions that influence well-being, and how these biases and emotional reactions are affected by cognitive training practices such as mindfulness meditation.
He has led several influential studies on the mechanisms of mindfulness training and depression vulnerability, highlighting that resilience against depression stems more from the growth of mindfulness-related skills, such as interoceptive awareness, than the eradication of residual depressive symptoms.
Show Notes
1:30 – How did Norm come to focus on the role of interoception in mindfulness, a practice so often described in cognitive terms (such as quietening the mind).
6:35 – On whether the interoceptive and default mode networks are anti-correlated
10:00 – Does mindfulness enhance your ability to perceive interoceptive signals from the body?
13:15 – How the experiential and narrative modes relate to depression
24:50 – How do people relate to the signals from within their body in a way that supports their wellbeing?
32:00 – How does the interoceptive way of looking at mindfulness relate to the positive effects of mindfulness in healthy populations?
40:00 – Are there any cultural factors that might be shaping our balance between narrative and experiential modes?
46:00 – Is there research on interoception and intuition?
48:20 – What is coming up next for Norm?
53:10 – Advice for students
1:30 – How did Norm come to focus on the role of interoception in mindfulness, a practice so often described in cognitive terms (such as quietening the mind).
Norm started thinking that meditation would be a process of quieting the self, and expected to see reduced activity in the brain regions associated with self-referential thought (regions now identified as part of the default mode network). What he instead found, was greater activation in regions responsible for sensory processing. And so, following the data, he came to see that rather than quietening the self-related brain regions, meditation enhances the ability to access other modes of self-knowledge that aren’t about conceptual self-evaluation. This finding came to make good sense when Norm later started meditating himself, and realised that at least in the early stages, that meditation is a sensory awareness practice with the instructions centred on sensations and the body.
6:35 – On whether the interoceptive and default mode networks are anti-correlated
At least in young adults, there is an opponency between task-focused and default-mode networks. However, this may not be the case for everyone. More importantly, however, the interoceptive network is not a task-focused network in the conventional sense; it doesn’t use the same parts of the brain that we use to make judgements or manipulate information from the external world.
10:00 – Does mindfulness enhance your ability to perceive interoceptive signals from the body?
No, mindfulness does not seem to make people ‘super sensors’, just as a concert pianist isn’t able to hear quieter sounds than other people. Instead, the concert pianist does more with, or gets more information, sounds. Similarly, mindfulness training seems support people become more in the habit of using information from the body. In the brain, we see that mindfulness increases the integration of interoceptive signals into overall evaluative parts of the brain (e.g. the anterior insula), rather than enhancing activity directly in primary representers (i.e. posterior insula) of what’s happening in the body. And the connection between interoceptive and evaluative parts of the brain is strengthened.
13:15 – How the experiential and narrative modes relate to depression
While the first episode of depression usually relates to some adverse circumstances, people can fall into mental habits that make them vulnerable to future episodes of depression. Where this is true, recurrent depression can be seen as a product of an overly rigid negative set of interpretations that are applied to a variety of events in life. But in depression, people also tend to suppress new sensory processing once they become sad. The more people suppress signals from the body, the more likely they are to experience relapses into depression.
So we see the opposite pattern activity from mindfulness: in depression there is a suppression of bodily signals and a dominance of conceptual-evaluative activity while in mindfulness there is greater integration of bodily signals relative to conceptual-evaluative judgements. From this perspective, mindfulness facilitates the opening to new (sensory) information that may serve to challenge the entrenched, negative mental patterns of depression. This opening to different information, contrasts with CBT where you challenge and restructure negative evaluations directly.
24:50 – How do people relate to the signals from within their body in a way that supports their wellbeing?
While depression relapse may be associated with the suppression of interoceptive signals following a negative cue induction, just paying more attention to interoceptive signals isn’t always associated with better outcomes. For example, interoceptive signals may be interpreted in a catastrophising manner in panic disorders. So it is a matter of relating to interoceptive signals differently, rather than just boosting them.
To start relating to interoceptive signals differently, people shouldn’t start by trying to focus on their body in the most unpleasant, triggering or patterned situations. Instead they should start small, in safe, pleasant situations and get in the habit of relating to your body differently. Once you are in the habit of relating to your body in an open, curious way, you can slowly progress to more unpleasant, triggering or patterned situations.
32:00 – How does the interoceptive way of looking at mindfulness relate to the positive effects of mindfulness in healthy populations?
Mindfulness can lead to a greater feeling of agency and presence, both of which are thought to be related to interoceptive signals. Strengthening of concentration is also likely to be a mechanism of beneficial effects.
Additionally, mindfulness can help us see the patterns in our thinking, feeling, and behaviour which we all have, but often become blind to. Seeing these habits better gives us the chance to evaluate them, and decide to change it if it doesn’t serve us.
40:00 – Are there any cultural factors that might be shaping our balance between narrative and experiential modes?
Our education system is all about moving into the conceptual and elaborative way of relating to experience. The complexity of identity in our modern cosmopolitan world also demands ready intricate narratives about who we are.
46:00 – Is there research on interoception and intuition?
Norm has been developing a lot of behavioural tasks that can be run online that can test aspects of contemplative training (for example, tasks that can measure how stable someone’s attention is) and how these aspects are applied (for example, people’s emotion regulation tendencies).
53:10 – Advice for students
Early on, there should be a decision made around whether you want your role to be someone who pushes the frontier vs. consolidate and clarify things that have already started to be discovered. Norm has always been somewhat of a maverick choosing things that are interested to him, rather than making choices that are safer in terms of leading to jobs.
If you are interested in being someone that pushes the frontier, it can be helpful to think about applying the principles leading scientists are using in other fields to your field of interest.
Norm also recommends people look into Open Science. Especially in the contemplative science field, the rigour demanded by Open Science is a useful way to distinguish yourself.
Today we speak with Dr. Nicolas Van Dam (@ntvandam), Senior Lecturer at the School of Psychological Sciences at the University of Melbourne and Adjunct Assistant Professor in the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai in New York.
Nicholas is a clinical psychologist and directs the Decision Making and Affective Learning in Emotional Conditions lab or DALEC lab. There he investigates the things that make us most like robots, including predictable and algorithmic processes in decision making models, and the things that make us least like robots, including interoception, self-awareness, introspection and meditation. The focus of both streams of work is to help those with high-prevalence psychiatric conditions, such as anxiety, depression and substance-use disorders.
In this conversation, we talk mindfulness. We discuss the state of mindfulness-related research and the implications for therapists and clinicians.
Show Notes
2:00 – On Nicholas’s research areas.
3:30 – How Nicholas came to study self-awareness and self-perception processes in relation to high-prevalence psychiatric conditions.
5:30 – On the state of the meditation research field at the time of the Mind the Hype paper
14:15 – Key points made by the Mind the Hype paper.
22:20 – On whether the disagreements about definitions of mindfulness are fundamental or academic
28:30 – On extracting mindfulness from its Buddhist context
47:20 – On mindfulness-based clinical interventions
53:25 – Should clinician’s be recommending mindfulness?
59:00 – The impact of the Mind the Hype paper.
1.02:20 – What is Nicholas focusing on now?
1.05:30 – Advice to students
1.07:30 – On neurofeedback in meditation
2:00 – On Nicholas’s research areas.
Nicholas studies the things that make use most like robots and those that make us least like robots. The things that make us most like robots include predictable and algorithmic processes like decision making models. The things that make us least like robots include interoception, self-awareness, introspection and meditation. The focus of both streams of work is to help those with high-prevalence psychiatric conditions, such as anxiety, depression and substance-use disorders.
3:30 – How Nicholas came to study self-awareness and self-perception processes in relation to high-prevalence psychiatric conditions.
Nicholas did his dissertation on a mindfulness based intervention. He also became fascinated with the observation that those suffering from high-prevalence psychiatric conditions who don’t seem to respond to treatment, tend to have high levels of repetitive negative thoughts, known as rumination. Also, Nicholas had also found meditation useful in his own personal experience, particularly to deal with stress.
5:30 – On the state of the meditation research field at the time of the Mind the Hype paper
The authors had been working on the paper for around 3.5 years before it was finally published. The authors had met at events hosted by the Mind & Life Institute. As mindfulness grew in popularity, the authors came to see the need for a corrective to the exaggerated claims in the media and in the work of some researchers. The intention of the paper was outline what we known, what we don’t know and what we should do regarding mindfulness research, with the hope of driving an improvement in the quality of research, and of communication around mindfulness.
It’s hard to say, but we certainly seem to be seeing more pushback against the exaggerated claims, as seen by the greater audiences attending to those critical of modern mindfulness, such as Ron Purser. But this is a good think if it helps the field course correct, and prevent exaggerated claims that might cause people to dismiss the field altogether. Despite the recent criticism, interest continues to increase – which may be because people continue to hope in mindfulness as a panacea (which it is not) or because there is now a commercial imperative and inertia behind it.
14:15 – On the key points made by the Mind the Hype paper.
There were three main areas explored by the paper; 1) On definitions and measurement, 2) Clinical implementation of mindfulness, and 3) The neuroscience of mindfulness.
The reality is that due to the lack of active controls and variability in clinical studies, and the confounding of different intensities and duration of practice in neuroscience studies, the evidence around mindfulness is less robust than is commonly believed.
22:20 – On whether the disagreements about definitions of mindfulness are fundamental or academic
One issue is that people use the word mindfulness to refer to a state, a trait and a practice. Another core issue is the wide variety in backgrounds that people come from in conceptualising mindfulness. This leads to problems such as measures not correlating to each other, they aren’t terribly reliable, they don’t reliably change in the expected direction with practice.
28:30 – On extracting mindfulness from its Buddhist context
There was a concerted effort to extract mindfulness from its religious Buddhist roots to make it more palatable to a secular audience and those from other religious traditions. Mindfulness may not be a coherent practice when extracted from its Buddhist context. However, in itself, it is not a religious practice and is compatible with secular sensitivities or other religious beliefs.
And so, when dealing with mindfulness is any way, we need to consider whether we are dealing with it as an attentional training practice, or a more traditional conception as a part of a contemplative life. Nicholas’s own research is probing this spectrum, looking at how much of each type of practice people need to see benefits. As practitioners, we need to be clear about what we are recommending and why, so that the exchange around the recommendation is informed in the way that one would expect when making a contract.
47:20 – On mindfulness-based clinical interventions
Very few studies have compared mindfulness-based clinical interventions to an active control and against gold standard treatment. It’s not that mindfulness doesn’t promise to be part of the suite of gold-standard treatments, but much more work needs to be done to adequately evidence this.
53:25 – Should clinician’s be recommending mindfulness?
Nicholas wouldn’t recommend mindfulness above psychotherapy of pharmacotherapy for a psychiatric condition. But if in his clinical judgment that it was a person that might benefit from mindfulness, and there reasonable evidence for their condition (for example anxiety, ruminative depression or chronic stress), he may suggest it with careful monitoring and supervision.
Clinicians should also be cognisant of adverse events, which occur in both psychotherapy and mindfulness. Much caution should surround a recommendation of intense mindfulness practice to people with a history of trauma, vulnerabilities to psychosis or a history of bipolar disorder. In these cases, mindfulness practices can be slowly titrated.
59:00 – On the impact of the paper.
There has been much interest about the paper, but it’s too soon to tell whether it has driven a change in the quality of mindfulness research, or whether engagement with the paper will bog down at merely obligatory citations acknowledging it as representing a view of the limitations of the research. Early indications are that people are actually engaging with the substance of the paper.
1.02:20 – What is Nicholas focusing on now?
Nicholas is focusing a lot on the dose-response issue. That is, how much of a given practice should people do to get an effect. He also continues to work on issues of measurement and definition and how meditation apps compare with and complement more traditional forms of instruction. Additionally he has started to look at what might be the common ingredients across different contemplative traditions.
1.05:30 – Advice to students
Identify people that are doing what you think you want to be doing and look at how they got there. More than likely, looking at such people will show that there is more than one path there, and the path to where you want to go is not linear.
1.07:30 – On neurofeedback in meditation
Nicholas considers the most helpful part of mindfulness apps to be the ability to nudge people towards more regular practice. He thinks neurofeedback guidance to a particular state would be less important.
