Self-awareness, self-regulation, and self-transcendence (S-ART): a

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  • REVIEW ARTICLEpublished: 25 October 2012

    doi: 10.3389/fnhum.2012.00296

    Self-awareness, self-regulation, and self-transcendence(S-ART): a framework for understanding theneurobiological mechanisms of mindfulnessDavid R. Vago* and David A. Silbersweig

    Functional Neuroimaging Laboratory, Department of Psychiatry, Brigham and Womens Hospital, Boston, MA, USA

    Edited by:Amishi P. Jha, University of Miami,USA

    Reviewed by:Jeremy R. Gray, Michigan StateUniversity, USAJudson Brewer, Yale UniversitySchool of Medicine, USA

    *Correspondence:David R. Vago, FunctionalNeuroimaging Laboratory,Department of Psychiatry, Brighamand Womens Hospital, HarvardMedical School, 75 Francis Street,Boston, MA 02115, USA.e-mail: [email protected]

    Mindfulnessas a state, trait, process, type of meditation, and intervention has provento be beneficial across a diverse group of psychological disorders as well as for generalstress reduction. Yet, there remains a lack of clarity in the operationalization of thisconstruct, and underlying mechanisms. Here, we provide an integrative theoreticalframework and systems-based neurobiological model that explains the mechanisms bywhich mindfulness reduces biases related to self-processing and creates a sustainablehealthy mind. Mindfulness is described through systematic mental training that developsmeta-awareness (self-awareness), an ability to effectively modulate ones behavior(self-regulation), and a positive relationship between self and other that transcendsself-focused needs and increases prosocial characteristics (self-transcendence). Thisframework of self-awareness, -regulation, and -transcendence (S-ART) illustrates amethod for becoming aware of the conditions that cause (and remove) distortionsor biases. The development of S-ART through meditation is proposed to modulateself-specifying and narrative self-networks through an integrative fronto-parietal controlnetwork. Relevant perceptual, cognitive, emotional, and behavioral neuropsychologicalprocesses are highlighted as supporting mechanisms for S-ART, including intentionand motivation, attention regulation, emotion regulation, extinction and reconsolidation,prosociality, non-attachment, and decentering. The S-ART framework and neurobiologicalmodel is based on our growing understanding of the mechanisms for neurocognition,empirical literature, and through dismantling the specific meditation practices thoughtto cultivate mindfulness. The proposed framework will inform future research in thecontemplative sciences and target specific areas for development in the treatment ofpsychological disorders.

    Keywords: mindfulness, meditation, contemplative, self-regulation, self-awareness, self, brain networks

    To study the Way is to study the self. To study the self is to forgetthe self. To forget the self is to be enlightened by all things. To beenlightened by all things is to remove the barriers between ones selfand others. (Dogen, 2002)

    INTRODUCTIONIn the last two decades, the concept of mindfulness as a state,trait, process, and intervention has been successfully adaptedin contexts of clinical health and psychology, especially withrelation to treating stress and targeting emotion dysregulation.Operationalizing mindfulness has been somewhat challenginggiven the plurality of cultural traditions from which the con-cept originates, the difficulty with which it is measured, and itsdistinction from its common usage [see Baer (2003); Dimidjianand Linehan (2003); Brown and Ryan (2004); Grossman (2008);Gethin (2011)].

    Generally speaking, there are two models for cultivating mind-fulness in the context of meditation practicea 2500-year oldhistorical model that is rooted in Buddhist science and a 25-year

    old contemporary model that is heavily influenced by Jon Kabat-Zinns Mindfulness-Based Stress Reduction (MBSR) course, anadaptation of specific Buddhist techniques intended for generalstress reduction (Kabat-Zinn, 1990). The historical model fortraining the mind has similar goals to the contemporary west-ern medical model: both are interested in reducing suffering,enhancing positive emotions, and improving quality of life.

    Although the contemporary view of the concept, mindful-ness is increasingly becoming part of popular culture, thereremains no single correct or authoritative version of mindful-ness and the concept is often trivialized and conflated with manycommon interpretations. Mindfulness is described as (1) A tem-porary state of non-judgmental, non-reactive, present-centeredattention and awareness that is cultivated during meditationpractice; (2) An enduring trait that can be described as a dispo-sitional pattern of cognition, emotion, or behavioral tendency;(3) A meditation practice; (4) An intervention. Dispositionalmindfulness is now measured by at least eight self-report scalesthat are often uncorrelated with each other (Grossman and VanDam, 2011). These semantic differences are problematic in the

    Frontiers in Human Neuroscience www.frontiersin.org October 2012 | Volume 6 | Article 296 | 1

    HUMAN NEUROSCIENCE

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  • Vago and Silbersweig S-ART: Mechanisms of mindfulness

    laboratory setting. Here we attempt to address this conceptualproblem by synthesizing a comprehensive conceptual frameworkof self-processing in the context of neurobiological mechanismsby which mindfulness functions and that focuses on the goals ofmindfulness-based meditation practice: to reduce suffering andcreate a sustainable healthy mind.

    The proposed framework for understanding mindfulnessfocuses on self-processing and the underlying neural sys-tems involved in self-awareness, -regulation, and -transcendence(S-ART). Different approaches to understanding mindfulnessmay focus on one aspect more than anotherS-ART attemptsto synthesize a unified framework that integrates the traditionalBuddhist and contemporary models. The S-ART frameworkoperates using the underlying premise that our perception, cog-nitions, and emotions related to our ordinary experiences can bedistorted or biased to varying degrees. Depending on certain dis-positional factors, these biases are sometimes pathological, butexist on a spectrum and may therefore be present without anyclear psychopathology. Within this framework, mindfulness isdescribed to reduce such biases through specific forms of mentaltraining that develop meta-awareness of self (self-awareness), anability to effectively manage or alter ones responses and impulses(self-regulation), and the development of a positive relationshipbetween self and other that transcends self-focused needs andincreases prosocial characteristics (self-transcendence). In sup-port of S-ART, six neurocognitive component mechanisms thatare highly integrated and strengthened together through inten-tional mental strategies underlying the practice and cultivationof mindfulness are proposed to modulate networks of self-processing and reduce bias. These mechanisms include intentionand motivation, attention and emotion regulation, extinction andreconsolidation, prosociality, non-attachment, and de-centering.Thus, rather than reducing mindfulness down to a unitarydimension, the S-ART describes mindfulness in a broader frame-work of perceptual, physiological, cognitive, emotional, andbehavioral component processes.

    OPERATIONALIZING MINDFULNESSINTEGRATING THEHISTORICAL AND CONTEMPORARY PERSPECTIVESDEFINING MEDITATION AND MINDFULNESS FROM THE HISTORICALPERSPECTIVEIn the historical Buddhist context, the term meditation is used totranslate the Sanskrit term bhvana and its Tibetan equivalentsgoms. Etymologically, the Sanskrit term connotes the notion ofcultivation, or causing to become and the Tibetan equivalent,refers to development of familiarity (Thera, 1962; Rahula, 1974;Bodhi, 1999; Jinpa, 2009). In light of these definitions, it shouldbe clear that a traditional emphasis of most meditation practiceis that of mental development, in which the practitioner is culti-vating a general sense of well-being and virtue along with a levelof deep familiarity with ones inner mental landscape, and onespatterns of behavior (i.e., nature of mind) (Rahula, 1974; Bodhi,1999; Wallace, 2011).

    One of the original translations of sati into the English word,mindfulness, was by Davids (1882). It was translated from thePali root, sati (Sanskrit: smr. ti), literally meaning memory, andclosely related to the verb, sarati, referring to the process, to

    remember. Most conceptualizations of mindfulness from theBuddhist perspective emphasize a close and constant connectionbetween the functions of memory and attention (Thera, 1962). Infact, on closer examination, mindfulness can be described as thecontinuous discriminative attentional capacity for encoding andrecollecting experiences efficientlywithout forgetfulness or dis-traction, and in the appropriate context (Thera, 1962; Analayo,2003; Wallace, 2006); however, from the classical Buddhist con-text, views on the concept of mindfulness vary considerably(Dreyfus, 2011; Dunne, 2011). The Satipatthana Sutta, one of themost influential Buddhist texts, describes the practice of mind-fulness as a direct path to the cessation of suffering, and as afundamental quality or skill amongst a set of