Meditation Neuroplasticity, and Mental Illness - Term Paper

M e d i t a ti o n , N e u r o p l a s ti c i t y , a n d M e n t a l I l l n e s s | 1

Meditation, Neuroplasticity, and Potential for Treatment Interventions

A brief history of the meditative practices,

their effects on neuroplasticity, and their potential as a treatment

intervention for an assortment of mental illnesses.


AbstractThe thrust of this paper is to provide a comprehensive review of meditative and mindful

practices and their effect on cognitive functioning and neuroplasticity. An additional drive of this

work is to assess the practical applications of these techniques, and have a look at the potential

for use as a treatment intervention for a wide variety of mental illnesses. There were a mix of

systematic reviews, case studies, and control trials that made up the body of evidence going into

this work. Subjects in the studies varied from children to the elderly. Some limitations with the

research are the wide variety of practices that exist, as well as the researcher’s ability to induce

proper meditative states on subjects. The evidence collected strongly correlates regional

alterations – in hippocampal, brainstem, and frontal regions to name a few – with meditative and

mindful practices. Furthermore, increases in grey matter concentration, white matter

concentration, and cortical thickness were all documented. The application of these techniques as

a treatment intervention yielded very promising results. Meditation and mindfulness based

practices displayed statistically significant markers of improvement in anxiety disorders, post-

traumatic stress disorder, schizophrenia, psychosis, depression, and obsessive-compulsive

disorder. More research needs to be done, and the practices need be standardized for clinical use,

however the current evidence suggests these ancient practices are of extreme value to the

treatment of mental health.


Introduction

Meditation is a spiritual and healing practice that developed on the Eastern side of the

globe. It has quite a rich and intricate history, as it has been traced back further than 5000 years

ago 1. The word meditation – like many English words – is rooted in Latin, and is literally

understood to be the act of engaging in reflection or contemplation 1. A collection of ancient and

traditional texts that were extracted from India known as the “Yoga Sutras”, act as guidelines for

living a meaningful and purposeful life 1. Embedded in these ancient texts are descriptions of

meditative practices, in which they attempt a rough description of it, calling meditation both an

inward reflection and a midpoint of a light focus and a total absorption within something 1.

Meditation is quite a broad term however, as it refers to an assortment of practices that may

range from relaxation techniques to exercises performed 2. For the purpose of clarification, this

work is inclusive of all mind-body exercise that incorporate both dynamic and static components

as well as union of breath and body awareness 13. A few examples of these exercises are

transcendental meditation, mindfulness training, Qigong, Tai Chi, guided imagery, and so on 13.

Therefore, when one refers to the term meditation they may be referring to this assortment of

practices, as any one of them apply a selection of emotional and attentional monitoring

approaches that are in theory utilized for ends such as developing well-being and optimizing

emotional balance 2.

While all variations of meditation are intended to enhance the capacity to be mindful, the

Buddhist traditions place a particular emphasis on cultivating mindfulness. For this reason, these

traditions have served as the primary source for the many and varied mindfulness techniques


now incorporated into Western psychotherapeutic practices 4. Despite the simplicity with which

meditation appears to convey, it actually involves a high degree of cognitive functioning as it is a

multi-faceted task that relies on an intense concentration in concert with more sensitivity of

awareness, emotions, thoughts and sensory experiences 4. It is widely believed that an individual

who engages in meditative practices is likely to welcome both short and long-term benefits as a

result of alterations to the brain anatomically and functionally 4. With the growing popularity and

prominence of these longstanding practices, it is important to understand what the current

empirical data shows of meditation’s effects on the brain, in addition to a realization of its

practical uses. Western psychologists and neuroscientists alike have engaged in what is now a

fifty year old pursuit to understand these relationships and its implications on human

consciousness, neurobiology and everything in-between 4.

Types of Meditation Referenced in the Literature

As was touched on earlier, meditation refers to a broad collection of practices and types

both in the meditative theory and history, as well as in the empirical literature pertaining to the

practice. Where the literature varies from the theory however, is with the broad and often used

stratifications developed to qualify the practices into a more specific mode of cognitive

functioning. Much of the research elected to term the two classifications as being either “open

monitoring (OM)” or “focused attention (FA)” types of practice, and if these exact terms were

not used, ones that refer to the same concept were instead 2. The former is described as involving

attention on moment-to-moment unfolding of experience with a detachment from judgement or

reaction to the contents of cognitive patterns 2. The objective of OM meditation is to broaden the


attention to all the sensations and emotions being experienced. The technique is said to develop a

deeper level of awareness as well as a non-judgemental monitoring of brain activity 3. The latter

incorporates a primary focus of one’s attention on a particular object of interest (David and

Lutz). It is further characterized by a focus on a specific external or internal object of interest

while shutting out unrelated stimuli 3. FA meditation is believed to aid in attentional skills,

awareness of distracting stimuli, and redirection of one’s focus 3. Together, these two

classifications of meditation make up the majority of the techniques that were assessed in the

literature reviewed.

Neuroplasticity and Changes in Cognitive Functioning

The practices of meditation and mindfulness aim to produce a state of altered cognitive

functioning, thus an understanding of how the brain itself can be altered is of utmost importance.

The human brain has not only been determined to be plastic, but the potential extent to which its

plasticity can reach is constantly evolving 2. Research has long since proven that it is not only the

brains of children which could change, but the adult brain as well 2. Any anatomical or functional

variance from exercises or experience which is long lasting is considered to be as a result of

neuroplasticity 4. It is believed to be responsible for neural rewiring, afferent and efferent

trafficking reorganizations, expansion of neural conncetions, and sometimes other physiological

changes on a cellular or molecular level 3. With a more developed understanding of

neuroplasticity from an empirical perspective, it is now believed to be an imperative function of

the human brain and is considered to be pivotal for the ability to adapt to environmental and

physiologic demands, as well as overall experience 3.


It was once difficult to account for changes in cognitive functioning and development,

however with the incredible evolution of imaging technology researchers have been able to

acquire a lot of new and relevant data about the brain in action 4. One technology above the

others is most prevalent in the literature due to its versatility as well as its degree of clarity and

spatial resolution 4. Magnetic resonance imaging (MRI) is used to create a 3-D image of the brain

and is utilized often to explore a specific region or type of tissue 4. The new advancements in

imaging technology were pivotal in capturing empirical, significant data corroborating the belief

that the human brain does indeed change. A largely referenced example is a study that compared

young adults learning to juggle with those who did not. The MRI results generated great

evidence of learning-induced plasticity, as brain areas affiliated with handling and storage of

intricate visual stimuli exhibited structural changes in grey matter 6. A major design of the study

was to ensure the experimental group had no juggling experience in order to attempt to isolate

the changes as being specific to the training stimulus 6. This study was later redone on sixty-year

old volunteers, and produced the same results as the younger volunteers in a different study

referenced earlier 9 .Another frequently cited study that also elected to use MRI technology

generated images of both London taxi drivers and control groups in order to get a look at how

considerable navigation experience would affect the brain 7. The article not only cites much

larger hippocampi – a region of the brain known to produce spatial representations of an

environment – than the control group counterparts, but also went as far as to correlate size of the

hippocampal region with time spent being a driver 7. This statistically significant data validates

the brains potential to cultivate regional expansions to accommodate a higher dependence on a

skill in question, and also presents a relationship between the amount of time spent doing a skill

and the corresponding amount of regional change 7.


Meditation and Mindfulness’ Relationship to Neuroplasticity and Cognitive

Functioning

Neuroplastic changes have been evidenced to be a feature of any skill development, thus

meditation and mindfulness skills are no exception 8. Current evidence demonstrates how motor

imagery alone is able to enhance motor skill learning and performance 3. The hypothesized

explanation is that the cognitive functioning usually accessed during performance of the

movement is still being accessed during visualization of the movement, thus the neural pathways

are still being used and developed 10. This was further explored in 2005 by Pascual-Leone et al,

where they looked to demonstrate through their research that mental practice alone is enough to

encourage the progression of neural pathways 5. His findings cite positive alterations in brain

function and performance 5, which is not entirely surprising when one considers that these

techniques have been prevalent in the training of athletes for quite some time 10.

Despite the success of imagery, much of the attention amongst researchers has been on

the more traditional FA and OM meditation and mindfulness techniques, for its array of

purported benefits beyond attentional improvement. These practices have been linked to

improvements in monitoring conflicts, and other cognitive functions as a whole 3. Tasks subject

to improvement can range from verbal fluency, to cognitive inhibition and even working

memory 3. In multiple meta-analyses, meditation was cited to be supported by many areas of the


brain, however the most notable and frequent are frontal, parietal, temporal, and hippocampal,

and even brain stem regions 3. The practice was also cited to correlate with increases in volume

and concentration of cortical regions, grey matter, and white matter although the grey matter was

seen more often 3. Articles exhibit these steady modifications in grey and white matter in both

long and short term practice 3. When one continues to practice meditation, there are also

variations at the behaviour level, as there is an increase in many cognitive processes. Working

memory, executing different movements, attentional performance and other cognitive

enhancements present meditation as a tool to improve process specific learning, increasing its

potential for application in different circumstances 3.

Articles suggest both FA and OM meditation styles are aimed at developing cognitive

processes as opposed to being a cognitive skill on their own. It is for this exact reason that the

changes induced by meditation practices are believed to endure the passing of time, as they are

amendments to the processing itself and span many brain regions affecting many skills and traits

10. This is believed to be due to arousal of broad regions and pathways responsible for

psychological processing during meditation 10. Recent literature substantiates this idea, showing

that changes in brain and cognitive function as a result of meditation were present both during

the meditative practice as well as unrelated external activity 10.

These modifications are not limited to function however, as structural changes in areas

typically activated during meditation have been noted to be larger in long-term disciples

compared to those who are considered novice 10. In a separate but related study, advanced

meditators who have accumulated a minimum of one-thousand hours of experience showed

correlations with increased cortical thickness in the brain region responsible for adaptive control


of behaviour 10. The sum of the findings in the current body of evidence indicates that FA and

OM techniques cultivate cognitive skills that associate with marked differences in brain structure

and function 10. Furthermore, these modifications are linked with improvements in performances

of both internal and external tasks, as well as a reinforcement of the cognitive functions 10.

Key Studies Pertaining to Mindfulness and Meditation on Neuroplasticity and

Cognitive Functioning

There are plenty of published works existing that present the effects mental exercise like

meditation and mindfulness can produce. A topic of interest amongst researchers is the long-term

effects of meditation, which can be observed by examining differences between those who are

very experienced practitioners of meditation against controls who have little or no experience in

the practice at all. One study in particular compared 20 of these long-term practitioners to 15

control subjects using MRI imaging, and what was found was differences in cortical thickness 11.

Experienced meditators had increased thickness in regions involving the observation of both

internal and external stimuli 11. What’s more is that there are at least four additional studies that

corroborate these findings of increases in grey matter in the same regions of the brain 11. Two of

the studies displayed increases in at least two brain regions, while other studies showed more

regions affected 11. Another publication looked at the variations of brain structure in healthy but

stressed individuals, and gave insight into the alterations that come about in Mindfulness Based

Stress Reduction practices. In addition to all the expected changes in brain regions mentioned

earlier, the region associated with stress – the amygdala – was cited to decrease in size, denoting

not only anecdotal evidence of decreased stress, but also quantitative evidence 11.


Potential Uses and Efficacy as a Treatment Intervention for Mental Illness

Once it was established that meditation and mindfulness based practices brought on very

consistent and significant findings, it was not long before the implications would be examined in

a practical setting. Mental illness comes in many different forms, all of which are rooted in

variations of cognitive functioning. The empirical literature suggests there are many positive

influences on cognitive function associated with meditation practices, thus researchers were

eager to test its potential efficacy amongst a selection of mental illnesses. The current body of

evidence looks at how anxiety disorders, traumatic disorders, psychotic illnesses and other

diseases affecting cognitive function are all affected by mindfulness and meditation practices.

Anxiety is a mental illness that is well known and has deep rooted empirical data

showing efficacies of both pharmacological treatment and traditional methods 12. An article

looking at meditation on a neurobiological level linked reduction of cortisol and catecholamine’s

– markers of stress and anxiety – to meditation practices 12. A meta-analysis consisting of mostly

good quality randomized-control trials was strikingly implicative. The implications were that

meditative therapies are more than capable of managing anxiety symptoms, and in some cases,

proved to be more effective than other alternative therapies including pharmacological methods

12. Meditative therapies have shown potential in treating post-traumatic stress disorder (PTSD) as


well 13. An article published in 2012 in the journal ‘Behaviour Modification’ by Lang et al

reports “between a third and a half of patients receiving empirically supported treatments for

PTSD do not fully respond to treatment” 13. A well done systematic review compiled evidence

from three diverse forms of meditative treatments. The findings were that mindfulness

meditation has firm data supporting its efficacy as a PTSD treatment intervention, however there

are still things to be levelled out. For this reason, it is considered to be best used in combination

with another treatment. The other two have less data to draw conclusions from, however they do

show initial promise for PTSD treatment 13. Other streams of mental illness that are candidates

for this intervention are schizophrenia and psychosis. There were a couple of rare cases from

forty years ago that exhibited subjects who had a psychotic episode as a result of the

intervention, thus caution is required 14. Recent clinical findings indicate subjects have a better

ability to deal with negative thoughts and images present in the mind after meditation retreats

lasting only a few weeks, with treatment once a week 14. Long-term improvements in psychotic

symptom severity, psychological functioning and frequency of re-hospitalization were some

promising findings that were the result of a mindfulness-based intervention on people affected by

schizophrenia 14. There are other case studies that corroborate these findings, and strengthen the

efficacy, and thus potential for meditative techniques as a potential intervention in clinical

treatment.

Conclusion

The conclusion one arrives at after revising the current body of evidence is that there are

significant, positive results from meditative practices. These techniques consistently exhibit their


neuroplastic potential which has been seen to affect a wide variety of brain regions. Changes in

lobe sizes, concentrations of grey and white matter, and cortical thickness were all extraordinary

findings that were produced by these practices. The most exciting implications of the research

are undoubtedly the clinical applications among sufferers of a myriad of different mental

illnesses. Complications that are currently being treated by pharmacological means are not only

extremely costly in almost any health care system, but they also come with potential side-effects

or dangers that may have a patient trading one problem for another. This treatment intervention

is absolutely free as it requires nothing but variations in focus and cognitive functioning. In

addition, it can be done absolutely anywhere. These two reasons alone break down many barriers

that stand in the way between sufferers of mental illness and the treatment they need. There is

plenty of allure to a treatment intervention that combines therapeutic and spiritual approaches, as

benefits to health can extend past a specific illness and can reach as far as an increase in overall

well-being. Mindfulness therapy interventions aid with increasing levels of self-acceptance,

empowerment, and other positive emotions. The future steps to take with meditative practices

and research is to try and standardize the practice more, without removing the heart of the

practice itself. In addition, those conducting studies are advised to be more conscientious when

approaching these practices, as the delivery and teaching of these techniques are of vital

importance to its success. Striving to do these two things better will provide for even more

consistent findings and a better understanding in how to prescribe meditation as a treatment

intervention. As a whole however, meditation and mindfulness practices appear to be a potential

strategy for developing a healthy, well-functioning brain and may prove to be a cost effective

solution to a very serious mental health pandemic that the western world currently finds itself

facing.


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Meditation Neuroplasticity, and Mental Illness - Term Paper

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