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Abstract
Cultivation of mindfulness, the nonjudgmental awareness of experiences in the present moment, produces beneficial
well-being and ameliorates psychiatric and stress-related symptoms. Mindfulness meditation has therefore increasi
incorporated into psychotherapeutic interventions. Although the number of publications in the field has sharply i
over the last two decades, there is a paucity of theoretical reviews that integrate the existing literature into a compr
theoretical framework. In this article, we explore several components through which mindfulness meditation exer
effects: (a) attention regulation, (b) body awareness, (c) emotion regulation (including reappraisal and exposure, exti
and reconsolidation), and (d) change in perspective on the self. Recent empirical research, including practitioners' self
and experimental data, provides evidence supporting these mechanisms. Functional and structural neuroimaging stu
begun to explore the neuroscientific processes underlying these components. Evidence suggests that mindfulness p
associated with neuroplastic changes in the anterior cingulate cortex, insula, temporoparietal junction, fronto-limbic
and default mode network structures.The authors suggest that the mechanisms described here work synergistically, es
a process of enhanced self-regulation. Differentiating between these components seems useful to guide future basic
and to specifically target areas of development in the treatment of psychological disorders.
Keywords
anxiety disorders, attention, cognition, consciousness, neuroscience, positive psychology, stress disorders
Mindfulness meditation has been reported to produce beneficial treatment of disorders and improvement of health; it has also
effects on a number of psychiatric, functional somatic, and been shown to produce positive effects on psychological well-
stress-related symptoms and has therefore increasingly been being in healthy participants (Carmody & Baer, 2008; Chiesa &
incorporated into psychotherapeutic programs (cf., Baer, 2003; Serretti, 2009) and to enhance cognitive functioning (Jha,
Grossman, Niemann, Schmidt, & Walach, 2004). A large body Krompinger, & Baime, 2007; Ortner, Kilner, & Zelazo, 2007;
of research documents the efficacy of mindfulness-based inter- Pagnoni & Cekic, 2007; Slagter et al., 2007). Historically, mind-
ventions in the treatment of a number of clinical disorders, fulness is a concept stemming from ancient Buddhist philoso-
including anxiety (Hofmann, Sawyer, Witt, & Oh, 2010; phy (Bhikkhu, 2010), and is practiced to achieve enduring
Roemer, Orsillo, & Salters-Pedneault, 2008), depression (Hof- happiness (Ekman, Davidson, Ricard, & Wallace, 2005) and to
mann et al., 2010; Teasdale et al., 2000), substance abuse gain insight into a view of the true nature of existence (Olen-
(Bowen et al., 2006), eating disorders (Tapper et al., 2009), and dzki, 2010).
chronic pain (Grossman, Tiefenthaler-Gilmer, Raysz, & Kesper,
2007). Furthermore, mindfulness meditation positively influ-
ences aspects of physical health, including improved immune
function (Carlson, Speca, Faris, & Patel, 2007; Davidson et al.,
Corresponding Author:
2003), reduced blood pressure and Cortisol levels (Carlson et al.,
Britta К. Holzel, Bender Institute of Neuroimaging, Justus Liebig-University,
2007), and increased telomerase activity1 (Jacobs et al., 2010). Otto-Behaghel-Str. 10 H, 35394 Giessen, Germany
Not only has mindfulness successfully been used in the E-mail: britta@nmr.mgh.harvard.edu
2. Body awareness Focus is usually an object of Increased scores on the Observe Insula, temporo-parietal
internal experience: sensory subscale of the Five Facet Mind- junction
experiences of breathing, fulness Questionnaire; narrative
emotions, or other body self-reports of enhanced body
sensations awareness
Physiological
Ongoing attempts to advance studies also support the proposition
the development of instrumthat
for the valid assessment of body
meditation awareness
training (Mehling
leads to decreased emotional reactivity et
2009) will help to further and
illuminate this
facilitates a return to connection.
emotional baseline after reactivity.
For example, experienced mindfulness meditators have
shown a faster decrease in skin conductance in response to
3. Emotion regulation aversive stimuli (Goleman & Schwartz, 1976), as well as less
enhancement ofthe
In this section, we first describe the startle response byfindings
general aversive stimuli reg
(Zeidler, 2007).on
ing the effects of mindfulness An electroencephalogram
emotion regulation. study found that T
we focus on two different emotion
mindfulness-based regulation
stress strategies
reduction training led to increases in
seem to be involved in mindfulness, namely,
left-sided anterior brain activation reappraisal
after the course compared
extinction. with a wait-list control group (Davidson et al., 2003). This pat-
Role of emotion regulationterninof lateralization
meditation has previously been associatedA
practice. withgrowi
the
body of literature suggests that
experience of mindfulness
positive emotions (Davidson, practice
1992). Similarly, resu
improvements in emotion regulation.
stronger relative left prefrontal Emotion regula
activation was also recently
found as a state effect
refers to the alteration of ongoing in previously depressed
emotional individuals fol-
responses thro
the action of regulatory processes (Ochsner
lowing a short practice & Gross,
of mindful breathing 2005
and loving kind-
Theravadan translations ofnessBuddhist teachings,
meditation (Barnhofer, the
Chittka, Nightingale, alterat
Visser, &
of emotional responses is Crane, 2010). These findings
addressed in thesupportSatipatthana
the proposition that S
in terms of the overcoming of practice
mindfulness sorrow and
has an effect distress
on the as par
physiological aspects
meditation practice: of positive emotions and thus positively influences emotional
processing.
This is the direct path for the purification of beings, for
the overcoming of sorrowNeural
and mechanisms of emotion regulation.
lamentation, for the Duringdisap-
emo-
pearance of pain and distress, for
tion regulation, the
prefrontal attainment
control of the
systems modulate emotion-
generative systems, such as the amygdala, which is responsible
right method, and for the realization of Unbinding
thought to
2005) be
positively correlated suppo
with extinction recall. In addition,
ation while the individual encounters the feared stimuli hippocampal activation has also been found to be involved in
(Wölpe, 1958), the relaxation component of meditation might
fear extinction recall. Functional connectivity analysis reveals
serve to maximize the effects of the extinction process. that the vmPFC and hippocampus work in concert during
In the Five Facet Mindfulness Questionnaire, the capacity
extinction recall to inhibit fear, suggesting that they comprise
to expose oneself to internal experience without reactivity is
a network that mediates the expression of extinction memory
captured in the Non-Reactivity to Inner Experience Scale. in the appropriate context (Milad et al., 2007). Hippocampal
Example items are "In difficult situations, I can pause without
activation during extinction recall is likely related to signaling
immediately reacting" (Item 21), or "When I have distressing
the extinguished context (contextual safety; Corcoran, Des-
thoughts or images I am able just to notice them without mond,
react- Frey, & Maren, 2005; Corcoran & Maren, 2001). The
ing" (Item 29). With completion of a mindfulness-based stress
amygdala has been implicated in both human and animal stud-
reduction course, scores on this scale increase with large effect
ies as playing a crucial role during the acquisition and expres-
sizes (Carmody & Baer, 2008), corroborating the theory sion that of conditioned fear (Davis & Whalen, 2001; LeDoux,
mindfulness practice leads to the self-perception of decreased
2000; Pare, Quirk, & Ledoux, 2004; Phelps & LeDoux, 2005),
reactivity. This likely is a mechanism for facilitating
including the detection of stressful and threatening stimuli and
exposure. the initiation of adaptive coping responses (Hasler et al.,
2007). When individuals regulate their emotions, the amyg-
Fear conditioning, extinction , and reconsolidation . The pro-
dala is thought to be down-regulated by the vmPFC and hip-
pocampus (Banks et al., 2007; Davidson et al., 2000; Milad,
cess of fear extinction has been studied extensively in the con-
text of conditioned fear. Fear conditioning is a learning process
Rauch, Pitman, & Quirk, 2006), both of which have extensive
in which a neutral conditioned stimulus (e.g., a tone) is paired
connections with the amygdala. This inhibition of the amyg-
with an aversive unconditioned stimulus (e.g., a shock). After
dalaa serves to suppress fear (Milad et al., 2006; Rauch, Shin,
& Phelps, 2006), thereby allowing control over behavioral
few pairings, the presentation of the conditioned stimulus comes
to also elicit various fear responses (e.g., freezing in animals;
reactions to emotions (Price, 2005). Deficits in fear extinction
sympathetic arousal in humans). Repeated presentations ofare thethought to be related to a number of psychiatric disorders,
conditioned stimulus in the absence of the unconditioned stimu-
and neuroimaging studies have shown that the aforementioned
lus result in the extinction of the conditioned responses. Extinc-
structures are dysfunctional in several psychiatric disorders,
tion does not erase the initial association between conditionedsuch as posttraumatic stress disorder (Milad et al., 2009),
and unconditioned stimuli but is thought to form a new memory
schizophrenia (Holt et al., 2009), and depression (Anand et al.,
trace (Quirk, 2002; Rescorla, 2001) or reconsolidate the2005).
old
memory with new contextual associations (Inda, Muravieva, &
Effects of meditation practice on the neural network
Alberini, 2011; Nader & Einarsson, 2010; Rossato, Bevilaqua,
Izquierdo, Medina, & Cammarota, 2010). After extinction train-
underlying extinction. There is recent evidence from ana-
ing, extinction memory is thought to compete with conditioned
tomical MR! studies that the aforementioned brain regions
memory for control of fear expression (Myers & Davis, 2007).
show structural changes following mindfulness meditation
Recent research has shown that successful extinction memory
training. Cross-sectional studies comparing mindfulness med-
itators and nonmeditators found that meditators showed
reliably differentiates healthy from pathological conditions
(Holt et al., 2009; Milad et al., 2008). Extinction learning and its
greater gray matter concentration in the hippocampus (Holzel
etof
retention may thus be a critical process in the transformation al., 2008; Luders, Toga, Lepore, & Gaser, 2009). Further-
maladaptive states. It allows individuals to learn not to have a
more, Holzel et al. (2011) recently observed that structural
fear response to neutral stimuli, when there is no adaptive func-
changes in the hippocampus were detectable within a period
of only 8 weeks in participants that underwent mindfulness-
tion for the fear response. Rather, individuals can flexibly elicit
other more adaptive emotional and behavioral responses. based stress reduction, and Holzel et al. (2008) found that
cumulative hours of meditation training were positively
Neural mechanisms of fear extinction and extinction correlated with gray matter concentration in the vmPFC in
retention. Recent fMRI research on fear conditioning experienced
has meditators. In a longitudinal study enrolling par-
identified a network of brain regions that are crucial for ticipants
the in an 8-week mindfulness-based stress reduction
extinction of conditioned fear responses and its retention.course,
As Holzel et al. (2010) found an impact of the stress-
outlined below, this network seems to strengthen through
reducing effects of mindfulness meditation on the amygdala;
mindfulness practice. The ventromedial prefrontal cortex
the greater the decrease in participants' scores on perceived
(vmPFC) has been shown to be important for the successful
stress over the 8 weeks, the greater a decrease they showed in
recall of the extinction (Milad & Quirk, 2002; Morgan, gray matter concentration in the right amygdala. Modified
Romanski, & LeDoux, 1993; Quirk, Russo, Barron, & Lebrón,
gray matter concentration in these regions that is dependent on
2000), with the magnitude of vmPFC activation (Milad et meditation
al., training might potentially be related to the improved
2007) and the cortical thickness of the vmPFC (Milad et al.,
ability to regulate emotional responses. Furthermore, fMRI
(Olendzki,involves
studies show that meditation 2010). When internal awareness becomes enhanced
activation of the h
campus and medial PFC (Lazar etmeditators
through meditation, al., 2000; Lou
report that they et al., 1
can observe
mental processes that
Newberg et al., 2001), suggesting with increasing clarity (cf. MacLean
regular et al.,
meditation
tice enhances the function20 of these
1 0) and brain
increasing temporal regions.
resolution. Addition
Within this enhanced
for those with social anxiety disorder,
clarity, the amygdala
process of a repeatedly activatio
arising sense of self becomes
reduced following 8 weeks observable
of to the meditator through development
mindfulness practice of meta- (Gold
Gross, 2010). There thusawareness.
appear to isbe
Meta-awareness a form striking similar
of subjective experience
in the brain regions beingandinfluenced
executive monitoring, in bywhich one takes a nonconceptual
mindfulness me
tion and those involved in mediating
perspective fear
as a distributed form extinction.
of attention toward the con- Th
tents of conscious experience
findings suggest that mindfulness meditationand the processes could
involved. dire
influence one's capacity Meta-awareness
to extinguish is not entangled in the conditioned
contents of awareness fea
(Deikman,
enhancing the structural and 1982; Raffone & Pantani,
functional 2010; Varela, Thompson,
integrity of the
network involved in safety& Rosch, 1991) and facilitatesThe
signaling. a detachment from identifica-
neuroscientific
siderations described heretionsupport
with the static sense of self. previously
the Rather than as a static entity
held v
or structure, the sense
that extinction might contribute toof self
somecan be experienced
of the as an event
benefic
effects of mindfulness (Olendzki, practice 2006). It has been postulated
(Baer, 2003;that paying close
Brown e
2007). attention to the transitory nature of this sense of self leads to
the "deconstruction of the self' (Epstein, 1988). The Dalai
The impact of extinction processes within meditation Lama describes the resulting understanding that practitioners
practice . The role of extinction processes in the improve- reach: "This seemingly solid, concrete, independent, self-
ments following mindfulness-based treatments is most obvi- instituting I under its own power that appears actually does not
ous in the treatment of anxiety disorders, which have reliably exist at all" (Gyatso, 1984, p.70). In place of the identification
been found to benefit from mindfulness practice (Kabat-Zinn with the static self, there emerges a tendency to identify with
et al., 1992; Kimbrough, Magyari, Langenberg, Chesney, & the phenomenon of "experiencing" itself.3
Berman, 2010; Roemer et al., 2008). Nonreactivity and the From a Buddhist perspective, identification with the static
successive extinction mechanism presumably also play a cru- sense of self is the cause of psychological distress, and dis-
cial role in the stress-reducing effects of mindfulness and identification results in less afflictive experience and the free-
might mediate decreased perceived stress scores (Carmody & dom to experience a more genuine way of being (Olendzki,
Baer, 2008; Chang et al., 2004). They might also be highly 2010). As the psychologist Jack Engler (2004) puts it:
relevant for the benefits of mindfulness in the treatment of When it is realized that no self is to be found in the ele-
substance abuse (Brewer et al., 2009). Beyond that, exposurements of our experience, it begins the process of liberation.
is pursued toward whatever emotions present themselves, Understanding that our sense of "I" is not as solid, permanent,
including sadness, anger, and aversion, as well as pleasant or substantial as we habitually hold it to be ultimately uproots
clinging, attachment, and hostility. Understanding this burns
emotions, such as happiness. We therefore suggest that extinc-
tion is effective during all of these emotional experiences, up the fuel that runs our repetitive habits. Those who have
leading to an overwriting of previously learned stimulus- understood this report a sense of spacious lightness and free-
response associations. Buddhist teachings claim that the non-dom. They exhibit deep concern and tenderness for others.
clinging to unpleasant and pleasant experiences leads to According to Buddhist philosophy, a change in perspective
liberation (Olendzki, 2010). Framed in Western psychological on the self is thus the key in the process to enduring forms of
happiness.
terminology, one could say that nonreactivity leads to unlearn-
ing of previous connections (extinction and reconsolidation) Whereas more advanced meditation practices are required
and thereby to liberation from being bound to habitual emo-to experience this drastic disidentification from the static sense
tional reactions. of self, a de-identification from some parts of mental content
is often experienced even in the earliest stages of meditation
practice. In mindfulness practice, all experiences are observed
4. Change in perspective on the self as they arise and pass. By closely observing the contents of
The essence of Buddhist psychology lies in the teaching that consciousness, practitioners come to understand that these are
there is no such thing as a permanent, unchanging self (Olen- in constant change and thus are transient. The mindful, non-
dzki, 2010). Rather, the perception of a self is a product of anjudgmental observation fosters a detachment from identifica-
ongoing mental process. This perception reoccurs very rapidlytion with the contents of consciousness. This process has been
in the stream of mental events, leading to the impression thattermed "reperceiving" or "decentering" (Carmody, Baer,
the self is a constant and unchanging entity. The self is experi-Lykins, & Olendzki, 2009; Fresco et al., 2007; Shapiro et al.,
enced as being the one who inhabits the body, being the one 2006) and has been described as the development of the
who is thinking the thoughts, being the one experiencing emo-"observer perspective" (Kerr, Josyula, & Littenberg, 2011).
tions, and being the agent of actions; having free will We suggest that although this stage is not yet the full
between
revealed an uncoupling of the each component
right insulamight seem
andartificial. We want to PFC, and
medial
illustrateof
there was increased connectivity the interaction
the of the components
right with an example:
insula with dorso-
During mindfulness meditation,
lateral PFC regions in the experiential focusthe meditator's the
after goal is to mindful-
maintain attention
ness training. The authors interpret to currentfindings
these internal and externalas
experiences
representing
with a nonjudgmental
a shift in self-referential processing, stance, manifesting
namely, asacceptance,
a shift curios- "toward
ity, and
more lateral prefrontal regions openness. When an emotional
supporting a morereaction getsself-detached
triggered
by thoughts, sensations, memories,
and objective analysis of interoceptive (insula)or external stimuli
and(e.g., a
exterocep-
tive (somatosensory cortex) memory
sensory events,
of a frightening rather
event), the executive than their
attention system
(Section 1) detects the conflictvalue
affective or subjective self-referential to the task goal of maintaining is repre-
[which
a mindful state. (Farb
sented by medial PFC activation]" Heightened body
et awareness
al.,(Section
2007, 2) helps p. 319).
to detect activity
Furthermore, given the higher physiological aspectsof
of the regions
feelings present (e.g.,
supporting
body and internal awareness, these
body tension, data
rapid heartbeat, also
short shallow suggest
breath), and the that
increased body awareness mightprovided information
be closely about the internal
relatedreaction to the
to stimu-
changes in
lus is a prerequisite for accurate
the perspective on the self, consistent with Buddhist philosophy.identification of the triggered
emotional response
Greater internal awareness might replace (i.e., fear).
theEmotion regulation processes narrative
previous,
form of self-reference. (Section 3) then become engaged, in order to relate to the
experience differently
Neuroscientific findings: Structural rather than with a habitual In
neuroimaging. reaction
the(i.e., recent
longitudinal structural studysimplymentioned
noticing the fear as opposed to engaging (Holzel
above in avoidance et al.,
mechanisms).
2011), the posterior cingulate cortex, The first two
the mechanisms (sustained attention
temporo-parietal
junction, and the hippocampus[1] to body awareness [2]) lead
showed to a situation of exposure,
increased gray and matter
the third mechanism (regulating for nonreactivity)
concentration following mindfulness-based stress facilitates
reduction.
Given the relevance of these response
brain prevention, leading to extinction and
structures forreconsolidation
the experi-
(3). Rather thanthat
ence of the self, it seems possible being stuckthein the habitual reactions to the changes
structural
external and internal
might be associated with changes in environment, the meditator can experi- on the
the perspective
encethat
self. It is interesting to note the transitory
thenaturehippocampus,
of all related perceptions, emotions,
temporo-
or cognitions in each moment
parietal junction, posterior cingulate cortex, of experience.
and The awareness
parts of of the
medial prefrontal cortex form the transitory
a brain nature of the self and one's momentary
network (Vincentexperi- et al.,
ence leads to a change
2006) that supports diverse forms of inprojecting
the perspective on the selfthe(4), where
self onto
another perspective (Buckner & processing
self-referential Carroll, 2007),
(i.e., the narrative including
of the relevance
of the stimulusabout
remembering the past, thinking for oneself) becomes
thediminished,
future while first-
(Schacter,
person experiencing
Addis, & Buckner, 2007), and conceiving becomes enhanced.
theThe entire process
viewpoint of
represents enhanced
others, also referred to as a theory ofself-regulation,
mind (Saxe which - according to
& Kanwisher,
Karoly (1993)
2003). These abilities have been - is defined as a process
suggested to thatshare
enables individu-
a common
als to guide their goal-directed activities information
set of processes, by which autobiographical by modulation of is
thought,
used adaptively to enable the affect, behavior, or attention
perception of via deliberate or auto-
alternative per-
mated use 2007).
spectives (Buckner & Carroll, of specific mechanisms.
Structural changes in
this brain network (involved in As illustrated
the by the example, the described
projection of components
the self onto
another perspective) may be mutually facilitate each other.
associated Attention regulation
with is espe-
the perceptual
cially important
shift in the internal representation ofand,the
as the basis
self of allfollowing
meditation tech- mind-
fulness practice. niques, appears to be a prerequisite for the other mechanisms
The change in the perspective onattention
to take place. Focused the selfevents
on internal isis precisely
neces-
sary in order forbut
described in the Buddhist literature practitioners
has to gain
yet an increased
to be awareness
rigorously
tested in empirical research. ofThe
bodily sensations
findings with the resultant ability to recognize
reviewed here exem-
the emergence
plify early steps in the process of emotions. The ability
of changing the to keep attention
perspective on
focused on conditioned
the self but are still far from addressingstimuli is also a prerequisite
the for the
experiences
described by highly trained successful
meditation extinction of conditioned responses. Enhanced Research
practitioners.
body awarenessway
studies that are currently under might be very
willcloselyhelp
related to the changes
elucidate this
process further and will givein us
the perspective
more on the self and might replace
insight into a narrative
the underly-
form
ing neuroscientific mechanisms. of self-reference. The change in perspective on the self
may result in reappraisal of situations in specific ways, which
might provide motivation for further development of atten-
Integration tion regulation and body awareness. As the components
The above described components (see Table 2 for a summariz- mutually facilitate each other, the occurring process could be
ing overview) are presumably highly interrelated. In fact, they understood as an upward spiral process (cf. Garland et al.,
might interact so closely with one another that a distinction 2011).
Self-Compas
practices vary in the degree to which they foster its increase.
Some types of practices are pursued with the primary goal of
The cultivating (self-) compassion (Germer, 2009; Salzberg,
concept of 1995), s
ness. while others strongly emphasize self-compassion within the
According t
self-compassion
context of traditional mindfulness meditation (Brach, 2003).
(being In mindfulness-based stress reduction, even and
kind though it is not u
perceivedthe declared primary goal of the program, self-compassion is
inadequ
self-critical),
implicitly and explicitly interwoven into meditation instruc- co
ences as tions, exemplified
part by reminders included in focusedofattention t
them asmeditation: "whenever
separatinyou notice that the mind has wandered
context off, bringdefined
it back with gentleness and kindness." The gentle
ings in yogabalanced
stretches are practiced with an emphasis on "exploring a
them" what feels good for oneself and one's body in this moment."200
(Neff,
(2003a), Whenever participants encounter physical pain or emotional
mindfuln
nents ofsuffering, they are encouraged to "take care of themselves."
self-com
In line with these practices, self-report studies show that
self-compassion scores increase over an 8-week mindfulness-
The relations
based stress reduction course (Birnie et al., 2010; Shapiro,
mindfulness Astin, Bishop, & Cordova, 2005; Shapiro, Brown, &
In their current conceptualization and operationalization Biegel, 2007; but also see P. D. Abercrombie, Zamora, &
within contemporary research contexts (Baer et al., 2006; Korn, 2007).
Neff, 2003a), mindfulness and self-compassion are highly cor-
related. The total score of the Five Facet Mindfulness Ques-
tionnaire and the total score of the Self-Compassion Scale
Self-compassion within the theoretical
have been found to be correlated (r = .69) in a sample of non- framework proposed here
meditators (Hollis-Walker & Colosimo, 2011). Assumptions Within the framework of mechanisms proposed in this study,
have been put forth about the nature of their relationship, and self-compassion is presumably most related to emotion regu-
it has been suggested that mindfulness is required in order for lation as well as to the change in perspective on the self. The
self-compassion to develop because the former enables one to generation of feelings of kindness toward oneself in instances
clearly see mental and emotional phenomena as they arise of perceived inadequacy or suffering (self-kindness) is an act
(Neff, 2003b). In line with this assumption, changes in mind- of emotion regulation. When cultivating self-compassion,
fulness have been found to predict changes in self-compassion seeing one's difficult experiences as part of the larger human
(Birnie, Speca, & Carlson, 2010). It has also been suggested experience rather than seeing them as separating and isolat-
that self-compassion partially mediates the relationship ing (common humanity) might initially require reappraisal.
between mindfulness and well-being (Hollis-Walker & Colo- This reframing might ultimately result in a change in the per-
simo, 2011). Furthermore, the cultivation of self-compassion spective on the self, where one relates to oneself in a less
has been suggested to explain much of the success of identified manner. However, there is currently only a very
mindfulness-based interventions. Kuyken et al. (2010) found small empirical basis for the explanation of the mechanisms
that the positive effects of a mindfulness-based cognitive ther- of self-compassion, and it is possible that unique aspects of
apy intervention on depressive symptoms were mediated by self-compassion are not addressed within the suggested
the enhancement of self-compassion across treatment. In components.
patients with anxious distress, scores on the Self-Compassion We are unaware of any published data on the neural corre-
Scale have been found to correlate more strongly with symp- lates of self-compassion in the context of mindfulness training
tom severity and quality of life than scores on the Mindful or on the neural basis of self-compassion (but see Lutz,
Attention Awareness Scale (Van Dam, Sheppard, Forsyth, & Brefczynski-Lewis, et al., 2008, for altruistic compassion).
Earleywine, 201 1). However, given the strong interrelatedness However, with the availability of the Self-Compassion Scale
of both constructs, it might be difficult to tease their effects (Neff, 2003a), there has been a drastic increase in the investi-
and relationship apart. gation of self-compassion in the context of mindfulness-based
interventions in the last few years, and a considerable body of
literature documents the improvement of self-compassion
The cultivation of self-compassion in with mindfulness meditation practice. The question about the
meditation practice exact nature of the relationship between both constructs and
Meditation is typically practiced with an intention - implicit their interconnection from an empirical and neuroscientific
or explicit - to cultivate self-compassion as well as compas- perspective will have to be revisited once more research is
sion toward other beings. Different types of meditation available.
components of
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Mindfulness-based stress reduction and attentional control. Clini-
Acknowledgme
cal Psychology & Psychotherapy, 14, 449-463.
The Arzy, S., Thut, G., Mohr, С., Michel, C.M.,
authors would & Blanke, О. (2006).
Brach, Neural basis of embodiment: Distinct contributions of
Patricia temporo-
Pop
this article.
parietal junction and extrastriate body area. Journal of Neurosci-
ence, 26, 8074-808 1 .
Declaration
Asada, H., Fukuda, Y., Tsunoda, S., Yamaguchi, M.,of
& Tonoike, M. C
The (1999). Frontal midline theta rhythmsdeclar
authors reflect alternative activa-
respect tion of prefrontal
to cortex and anterior cingulate cortex in humans.
their aut
Neuroscience Letters, 274, 29-32.
Funding Austin, J.H. (2006). Zen-brain reflections. Cambridge, MA: MIT
Britta К. Holzel was supported by a Marie Curie International Press.
Outgoing Fellowship within the Seventh European Community Baer, R.A. (2003). Mindfulness training as a clinical intervention: A
Framework Programme. conceptual and empirical review. Clinical Psychology: Science
and Practice, 10, 125-143.
Notes
Baer, R.A., Smith, G.T., & Allen, K.B. (2004). Assessment of mind-
fulness by self-report. Assessment, 11, 191-206.
1 . Telomeres are protective DNA sequences at the ends of chromo-
somes that ensure genomic stability during cellular replication.
Baer, R.A., Smith, G.T., Hopkins, J., Krietemeyer, J., & Toney, L.
Telomerase is the cellular enzyme responsible for telomere(2006).
lengthUsing self-report assessment methods to explore facets
of mindfulness. Assessment, 13, 27-45.
and maintenance. Telomerase activity has been found to be a predic-
Banks,
tor of long-term cellular viability that decreases with chronic S.J., Eddy, K.T., Angstadt, M., Nathan, P.J., & Phan, K.L.
psycho-
logical distress (Epel et al., 2004). (2007). Amygdala-frontal connectivity during emotion-regulation.
2. For the sake of completeness, it should be noted that someSocial Cognitive and Affective Neuroscience, 2, 303-312.
studies
Barinaga,
have not found this pattern of higher PFC and lower amygdala M. (2003). Buddhism and neuroscience. Studying the well-
acti-
trained
vation while participants were decreasing negative affect (Urry et al.,mind. Science, 302, 44-46.
2006). Barnhofer, T., Chittka, T., Nightingale, H., Visser, С., & Crane, С.
3. Of note, this decreased identification with the self is fundamen- (2010). State effects of two forms of meditation on prefrontal
tally different from pathological versions of depersonalization. For a EEG asymmetry in previously depressed individuals. Mindful-
detailed discussion of this distinction, see Engler (1995). ness (NY), 7,21-27.
Beauregard, M., Levesque, J., & Bourgouin, P. (2001). Neural cor-
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