of Google University and I'd like to introduce Philippe Goldin. Philippe, just a moment aback,

his background is a Postdoctoral Researcher. Philippe Goldin is a Postdoctoral Researcher

in clinically applied Affective Neuroscience in the Department of Psychology at Stanford.

Hold a PhD in clinical psychology from Rectors. He also spent six years in India and Nepal

studying languages, Buddhist Philosophy and Debate, which means that he can prove you

wrong in a nonviolent way in languages that you don't even understand. Philippe is currently

doing clinical research funded by the NIH in three areas. And here I have to read because

otherwise, I'll say it all wrong. Neuroimaging Investigations of Cognitive Effective Mechanisms

in Healthy Adults and Individuals with various forms of Psychopathology. The Effective Mind

fullness Meditation and Cognitive Behavioral Therapy on Neural Substrates of Emotion and

Attention Regulation. And the Effect of Child Parent Mindfulness Meditation Training. The

question is, "Why does this matter?" Philippe and his colleagues are working on understanding

how meditation affects the brain. And I can think of at least four implications for this.

One is that meditation is moving out of the realm of faith-based practice into the realm

of recognized science. Two, as this research is better accepted, more people will practice

and benefit from meditation. Three, you will be able to submit cost of your Zafu and Zabuton

as medical expenses, although not this year. And fourth implication, if you haven't already,

you should immediately go to go/siy and sign up for the next round of Search Inside Yourself,

Google's own mindfulness-based emotional intelligence class. So without further ado, please take

a deep breath, focus, and join me in welcoming Philippe Goldin whose talk today is entitled

the Cognitive Neuroscience of Mindfulness Meditation.

>> GOLDIN: Wow! Thank you so much. That was a beautiful introduction. So, without further

a do, just thank you very much for the opportunity to be here, and to share some ideas and open

questions and suggestions, and well, let's start. So today I'm going to speak briefly

a little bit about Attention, Mindfulness and Brain Systems, some cutting edge research

where there's a huge amount of interest, both from a clinical side, because I'm trained

as a clinical psychologist, psychotherapist, and also Neuroscience. I'm also trained as

a Neuroscientist. But how--what really--how does the brain work, how is it plastic, how

is it influenced by different types of training? I'm only here in front of you because there

are hundreds of people who've influenced me, some of whom are here, people who've taught

me brain imaging, how to sit with patients, how to become a husband, how to practice meditation

and so forth. So really, I'm here, but there's hundreds of other people who really, through

their kindness, that's why I can stand here in front of you. So, in brief, I'm going to

speak a little bit about Mindfulness Meditation, one particular type of meditation practice,

and then look at a clinical application: how might one type of practice, Mindful Based

Stress Reduction, be used as a clinical intervention for adults suffering from Social Phobia or

Social Anxiety Disorder? There are many types of mediation practice. And that's something

that's very important. The word gome in Tibetan, bavna in Sanskrit, really refers to cultivating

a certain quality of mind. So its practices that help us cultivate a quality and there

are many ways to do that. So there's--just simply put, there are some classes of meditation

practices that really have to do with harnessing attention, focusing and developing concentration.

So, for example, breath, body, focused meditation, visualizing an image, a mantra, or listening

to a sound, or certain object list open field. These are different kinds of meditation practices

that they have different types of results. Then there's also linguistic, analytic linguistic

or reasoning, as exemplified by monks doing analytic debate which I did when I was I India

in Tibetan Buddhist monasteries and it's really, really fun. And this here could be taking

a topic like the precious human rebirth; working here at Google, why is that such an amazing

thing; the death meditation, generating love and kindness, these would all be objects of

analytic thinking, linguistic, logic types of meditation. And then, the gem of all, the

actual medicine, well, one form of medicine is meditation on emptiness, in Sanskrit, shunyata.

And this has to do with dissolving a mistake in view of how I exist, how we exist, and

transforming that into a view of how one exists that is a lot more fluid and healthy. So that's

another form of meditation practice that is really these two build up to doing this. So,

in the field of clinical interventions, clinical psychology, etcetera, there's a huge, huge

bursting interest in applying eastern concepts, eastern meditation practices, acceptance,

mindfulness, into western clinical practices, interventions. So for example, one of the

most popular Mindfulness Based Stress Reduction, I believe you had John Kabat-Zinn here recently.

So this is really fascinating because he took people who were basically coming out of pain

clinics in UMass who the doctors were like "Look, we've done surgery, we've drugged them

up with lots of medications, we've done everything we can, we're tired of them, you take them."

And he basically said "Okay, I'll do it." And he caught a fad and created this program

"Mindfulness Based Stress Reduction" to help people with chronic, physical and emotional

pain, 30 years ago. Next year it'll be 30 years. So he's infiltrated the medical system

in a away that no one else has done to make it legitimate, to bring techniques, to help

people deal with themselves in a way that's really concrete, fundamental. Beautiful. Another

derivative that's really fascinating is Mindfulness Based Cognitive Therapy, literally a hybrid

of one of the best forms of psychotherapy, cognitive therapy and Mindfulness Meditation,

specifically as a treatment to prevent relapse into major depression. So this is to help

people who have three or more previous major depressive episodes, and helping them to prevent

relapse into the subsequent depressive episode. So this has been very, very efficacious and

wonderful clinical trials across three different study--three different continents. Another

form is Dialectic Behavior Therapy which specifically incorporates Mindfulness Meditation as one

of the techniques to help people primarily with borderline personality disorder, but

it's been extended to eating disorders as well. And then acceptance and commitment therapy

is another kind of clinical practice that is explicitly incorporating mindfulness and

Buddhist's ideas without talking about Buddhism at all. So these are just some examples of

how it's being incorporated in clinical practices right now. What I'm going to focus on for

today is Mindfulness Based Stress Reduction as a type of intervention. First question

is what is that? So it consist of three different components: formal meditation practice, breath

focused, body scan of sensations, being able to shift attention volitionally from different

sensory modalities, generating compassion, loving, kindness state of mind, and then there's

informal meditation practice which is just as important as the formal sitting which is

10, 15, 20 times per day, just for even one breathe. So you can do it even right now,

just shift your attention to your own breathe just for one cycle, to breathing in and breathing

out. So we ask people to do this anytime, anywhere, any situation, multiple times a

day to build the muscle of attention, to generate the habit of checking in, dropping in. Oops!

And then the third component is Hatha yoga, physical stretching which is also a way of

getting into the body, noticing sensation. So this is the program, so to speak, that

we used for adults with social anxiety. Mindfulness has been shown over the past 30 years across

numerous clinical studies to be very effective and robust for reducing stress, pain, anxiety

and depressive symptoms overall. Mindfulness Based Cognitive Therapy has been shown to

be excellent as a relapse prevention, not a treatment for major depression, but a treatment

to help prevent the next depressive episode. What is mindfulness? As defined by John Kabat-Zinn,

paying attention in a particular way. From the psychological side, what we think about

that is, attention has many components. Here, we're focusing on the ability to alert, place

your attention on an object. The ability, when the mind becomes distracted, to reorient,

the ability to have a specific goal and to use top down or executive control to stay

on target. All kinds of qualities that are needed to get anything done. Doing this on

purpose, meaning I have an intention, a motivation why I'm engaging in this training of my attention.

Doing it in the present moment, meaning avoiding, avoiding now. So it's experiential approach.

Most of our life is about avoiding, avoidance of things that are not pleasant. Here, this

is really bringing a sense of equanimity to what's changing from moment to moment to moment

without pushing away things that I don't like, pulling in things that I do like. Embracing

anything, everything. So it's experiential approach, not easy to do. In trying to do

this non-judgmentally, meaning bringing, instead of an attitude of self-deprecation "I really

suck at this. I'm not good at this. I'll never learn how to meditate. I can't stand my mind."

Instead, bringing an idea of acceptance, curiosity, openness, about what is happening in my mind,

my mental experience, my brain. Here's a quick process model. The intention could be simply,

"I want to reduce my stress. I want to reduce the symptoms of anxiety." It could be that

"I want to increase well-being." Or could even be used as self-exploration and possibly

even enlightenment, if that's what you're interested in. So for example, you could follow

the breath and you're trying to develop attention, concentration and open awareness, calm, flow,

for example. But inevitably, the mind becomes distracted, often within seconds. In that

moment, you--either can begin to ruminate, spin. I talked about people going into a soap

opera mode for hours or minutes or days at a time, fantasizing, dozing. These are all

forms of distraction. But then inevitably, what has to happen with awareness is to redirect,

reorient attention and to do this without sub-judgment but in fact, doing it with kindness

and curiosity. And in fact, it's when the mind is distracted and when it becomes aware

and brings it back, that's a key moment. That's actually where a lot of learning takes place.

Mindfulness consists of, in this Japanese calligraphy, awareness, heart, mind. And I

think that's telling, trying to bring those qualities together. What mindfulness is not,

is equally important to consider. It's not distraction, and I'll show you some data,

shortly. It's not suppression of emotional experience or suppressing showing one's emotion.

That is not mindfulness. It's not avoidance. It's not ruminating or spinning on something

positive or negative, it's not that. And it's not cognitive reappraisal or thinking in a

way to change the meaning of something that's going on. It's not a logic thinking language

process. Some of the potential mechanisms for mindfulness has to do with decentering,

disidentifying from the contents of mind. So as I have thoughts, sensations, images,

memories, those are events that are occurring but they're not me. So this is decentering

or disidentifying. Another possible mechanism is developing attentional focus, harnessing

the ability to place and maintain attention. Regulation of emotion. Obviously as one trains,

this can harness your attention, things that would normally distract or evoke emotional

off-balance will occur at less and less frequently. Changing in how we view our self arises inevitably,

implicitly, through doing this kind of practice. And then, it's also been thought that negative

self-focused spinning or ruminating is decreased. So, this is a study that my wife and I did

awhile ago where literally, just in a sample of people with mixed anxiety depression; we

found that, compared to a wait-list control, no change. We found that people with mind--who

did the mindfulness course, actually showed a significant reduction, post mindfulness-training,

compared to a wait-list. In negative--I'm sorry.

>> What's a wait-list? >> GOLDIN: A wait-list control is people were

randomized either to waiting several months before they started the mindfulness class

versus people who got it right away. So this is mixed--these are people with mixed anxiety

depression and what you see is that there's, from pre to post mindfulness-training, a reduction.

But more importantly, the amount of meditation that people practiced during the two and a

half months, predicted significantly, 50% reduction in rumination.

>> [INDISTINCT] >> GOLDIN: Yes. Good point. So this is actually--people

with the mindfulness--for some reason, the people who were assigned to the mindfulness

group, reported greater rumination at baseline. So, there way to--there are statistical ways

of dealing with that, but that's also why we need multiple studies than you average

over them and then those things like that hopefully drop out. Those same question, yeah,

yeah. So they were more elevated than negative rumination, the sample at baseline. Giving

his talk. So I'm sure that everyone here at Google, almost everyone, probably has to do--to

be evaluated on performance. The most fearful, feared, social performance activity in the

world is for public speaking. Fortunately I don't have that, but a lot of people do.

And not only is it fearful, maybe in the moment, when somebody has to present in front of peers

or managers or bosses or CEOs, but people will ruminate, it was what were talking over

lunch, some people will actually--in my [INDISTINCT] with me for two weeks, before talk has to

be given. Negative, you know, anxiety, diarrhea, fear, sleeplessness. So this is something

that a lot of people experience. So this is the most fearful social performance thing,

but there are many, many others as well. So what is social anxiety? Well, it has a huge

lifetime prevalence in North America. About 12% of adults in North America will meet criteria

for social phobia or social anxiety disorder. It's the third most common psychiatric condition

after major depression and alcohol substance abuse. Third most common. It has a very early

age of onset. Eighty percent of cases of social anxiety begin before the age of 18. In fact

it's the model time of onset is really about age 10, 11, 12. And it's often undiagnosed,

untreated, or even if somebody shows up treatment for anxiety, the clinicians usually don't

ask about social anxiety. So it's usually occurs early and it usually precedes the subsequent

development of major depression, substance abuse, and other anxiety disorders. The other

very important thing about social anxiety in its early age of onset is that, it's associated

with the highest high school drop-out rate of all of the anxiety disorders: OCD, panic,

generalized anxiety, agoraphobia, etc, etc. So this is really why people are interested

in going younger, younger, younger. So, what is social anxiety from the first person experience?

So we--for all of our participants, we ask them to identify four painful social situations.