terça-feira, 24 de agosto de 2010

meditation and life quality

OPTIMIZING LEARNING & QUALITY OF LIFE
THROUGHOUT THE LIFESPAN:
A Global Framework for Research & Application

Joseph Loizzo, M.D., Ph.D.
Assistant Professor of Psychiatry in Complementary & Integrative Medicine,
Cornell University College of Medicine
Visiting Scholar of Indo-Tibetan Studies,
Columbia University Graduate School of Arts & Sciences
Founder and Director, Nalanda Institute for Meditation & Healing

Conference on Longevity
Co-Sponsored by The Complementary Care Center of Columbia Presbyterian Hospital
& Tibet House US at Menla Mountain Retreat, Phoenicia New York
September, 2006

Contact:
Joe Loizzo, Director
Nalanda Institute for Meditation & Healing
16 East 65th Street, 4th Floor
New York, NY 10021
www.nalandameditation.org
joeloizzo@nalandameditation.org

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Background and Significance

Of all aspects of aging, none seems more crucial to human quality of life than the
preservation or decline of mental functioning.

This panel explores the new optimism about the aging mind-brain, touching on several promising lines of research in stress-reduction,learning enrichment and quality of life.

Previous panels have reviewed the growing evidence that the rate and quality of aging is not genetically fixed but subject to wide-ranging variation due to environmental, psychophysical and lifestyle factors (Sapolsky et al, 1986; Lesnikov & Pierpoali, 1994; Pierpaoli, 1998).

This variability is most dramatically illustrated by two complementary lines of research: McEwan’s work on the systemic effects of stress (Shulkin et al, 1994, 1998) and Pierpaoli’s work on the biology of regeneration (Pierpaoli et al, 1991, 1998, 2000; Bushell, 2005).

Not surprisingly, variability at the level of general physiology has been found to apply at the level of mental capacity, neural structure and function by two parallel lines of research in neuroscience and neuropsychiatry: Darnell’s work on the corrosive effects of traumatic stress on mind and brain (Darnell et al, 1994; Bremner et al. 1994; McEwan & Sapolsky, 1995) andRosensweig’s work on the environmental enrichment of neural plasticity and learning (Rosensweig & Bennet, 1996; Carney et al, 1999; Shimamura et al, 1995).

Previous panels have drawn attention to the existence of cultural traditions and practices meant to protect the mind and body from stress, trauma and illness and also
cultivate and replicate healing and rejuvenation.

Crucial to our focus in this panel is the fact that the ultimate application of the technology of self-regulation in these traditions is the preservation, rejuvenation and extension of mental capacity through contemplative methods of enriching plasticity (Skt. pra?rabdhi) and learning (adhi?i ya).

A growing body of findings from basic and clinical studies of various meditation techniques has given general support to traditional claims that contemplative practices help self-regulate and enhance mental functioning in the cognitive, affective and behavioral domains My own work has been on the rigorous and systematic methods of self-regulationpreserved in the Indian and Tibetan traditions (Loizzo & Blackhall, 1998; Loizzo, 2000).

While much of meditation research focuses on virtuouso practitioners, one of the great contributions of Indic traditions is the systematization and simplification of practice for public health and education (Carlson et al, 2003; Loizzo et al, 2006).

Thus my overview focuses on both basic research on virtuoso meditators as well as clinical research on methods of teaching novices and the general population.

In this way, I hope this panel will

not only elucidate the optimizing mechanisms and effects of contemplative practices but also show how contemplative lifestyles can be generally applied outside the lab or monastery, in mainstream clinical, business and educational contexts.

Research & Theoretical Framework

One way to summarize this brief overview is to say that recent physiological and

neuropsychiatric research has given us a picture of the relationship between aging and mental capacity far more complex and variable than previously thought.

The picture is

more complex because it challenges the conventional wisdom that aging and mental

decline are inexorably linked in a simple, linear progression, varying only in rate not

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overall curve or direction (Sapolsky et al, 1986; Frolkis, 1993; Eppel et al, 2004). It ismore variable because current research shows that external and internal factors may yield wide variations from psychoneural decline to enrichment (Mattson et al, 2002; Conboy et al, 2005); and because it also shows that such variation is possible in both synchronic and diachronic dimensions (Lesnikov & Pierpoali, 1994; Pierpoali, 1998; Bushell, 2005).

So

any comprehensive attempt to study or explain the relationship between mind/brain capacity and aging must seek a broad integration of a variety of research and theoreticalperspectives.

Also, given the cross-cultural scope of this conference, we have a further

burden in that any rigorous attempt to link Western research with Asian practices that may

advance basic science or clinical application requires a more or less coherent translation between widely divergent cultural paradigms of valid knowledge and method.


Over the years, I have developed an interdisciplinary, cross-cultural framework for
research and teaching in this challenging area (Loizzo, 2000).

This global framework assumes McEwan’s model of allostatic load as a measure of the wear-and-tear caused by consistent aversive stimulation and stress hormone exposure (Sapolsky et al, 1986; Shulkin et al, 1994).

Following McEwan, it applies that model to explain findings of cortical atrophy, decreased neurogenesis and declining function in mental disorders from trauma to depression as failures in adaptation to environmental challenges (Darnell et al, 1994;Bremner et al. 1994; McEwan & Sapolsky, 1995; Sheline et al, 1996).

At the opposite end of the spectrum, the framework assumes Rosensweig’s model of environmental enrichment

as a measure of the use-dependent increase in mind/brain function caused by consistent positive reinforcement and exposure to growth factors like melatonin (Rosensweig and Bennet, 1996; Obler & Fein, 1988; Csikszentmihalyi, 1990).

It then applies that model to Optimization

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social learning contexts as successes in adaptation to environmental challenges

(Shimmamura et al, 1995; Bushell, 2001; Lazar et al, 2005; Fredrickson, 2005).

The framework links the two models by hypothesizing that they are limiting cases in a synchronic spectrum of mind/brain functioning that ranges in a biphasic continuum from the worst case of traumatic stress-reactivity to the best case of optimal learning and creativity (Lesnikov & Pierpoali, 1994; Ryff & Singer, 1998; Rosenkranz et al, 2003;

While these models describe a range of neurophysiology, they line up quite naturally with models that describe the spectrum from traumatic to optimal mental

functioning in terms of a corresponding range in neuropsychology.

Traumatic functioning has been linked with patterns of cognitive dissociation, aversive affect and stereotyped behavior (Shulkin et al, 1994; Morgan et al, 2004).

Since such patterns are not just the effects of aversive conditioning but also causative factors in the stabilization and

reinforcement of stress-reactive maladaptation, they figure in the framework as cognitive, affective and behavioral forms of allostatic resistance or drag. An extreme model of this mode of reactive neuropsychology is the short-circuiting of cortical processing by amygdalar startle circuits under conditions of experienced threat (Skuse et al, 2005).

A less complete dissociation, between verbal and non-verbal cortex, positive and negative affect,is normal in the ordinary waking state under perceived stress (Warrenburg & Pagano, 1983; Delmonte, 1995; Shapiro et al, 1997)

Both forms of processing offer models of how stress-reactive mental functioning defaults to an impoverished mode of automatic information processing with decreased attention and learning .

The opposite, enriched mode of neuropsychological functioning is linked with enlarged working memory,enhanced cognitive association, positive affect and behavioral spontaneity and creativity

Since such patterns are not just the effect of positive conditioning but also causative factors in stabilizing and reinforcing optimal adaptation, they figure in the framework as cognitive, affective and behavioral forms of allostatic facilitation or lift.

One research model of this neuropsychological mode is virtuoso musical processing, in which normally dissociated verbal and non-verbal

modules are linked in a network that gives musicians greater attention, recognition,

appreciation and mastery of musical processing (Limb et al, 2006). Here again, the framework hypothesizes that these two models represent limiting cases in a biphasiccontinuum of neurpyschological functioning.from stress-reactivity to optimal creativity.

An insight common to modern observers as early as Freud and ancients as far back as

Empedocles and Shakyamuni is that the stress-reactive and enriched growth modes of

mind/body function seem to be reciprocally inhibitory (Freud, 1923; MacLean, 1959;

Doidge, 1990; HH Dalai Lama, 1995; Loizzo, 2000).

In the dimension of comparative biology, this insight has prompted modern and

ancient observers to place their binary frameworks of stress or enrichment in the context of

an evolutionary view of human life (Doidge, 1990; McEvilley, 2002). Since the human

brain evolved as a hybrid of three successive mind/brains which take turns driving the

overall system, in stress or trauma higher systems default to a survival mode of worst-case

projection, defensive emotion & fight-flight reflexes run by the reptilian brain’s stress

response (MacLean, 1959; Panksepp, 1998). This primitive response appears to have been

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preserved as a conservative mode to protect mammals from predators in the wild (Bracha,

In contrast, the evolution of self-regulation is based on a complementary growth-

and-reproductive mode of reptilian brain function and involves the mammalian synergy

between enlarged cortex, enhanced social learning and greater safety and abundance

through cooperation. It reflects an enriched, abundance mode based in the biology of sex

and inhibiting the stress-based survival mode (Doidge, 1990; Panksepp, 1998). This mode

enhances fertility, nurturance, empathy and social learning, capitalizing on windows for

childrearing (Carter, 1998). It fosters an outlook of open curiosity; an emotional style of

trusting self-disclosure and behavioral style of conscious mind/body sensitivity, tending to

optimize higher mind/brain functioning (Panksepp, 1998).

The ability to switch from survival to abundance mode likely grew more crucial as

isolated periods of abundance gave way to stable agrarian surpluses and civilization.

Religious disciplines like contemplation seem to work by cultivating a natural, mammalian

capacity to disarm worst case defenses and reset the mind/brain for optimal social living

and learning (Thayer et al, 1994; Riff and Singer, 1998; Dietrich, 2003). Meditative and

therapeutic techniques like mindfulness, free-association and hypnosis share brain features

like greater functional coherence, more lateral cortical balance, better vertical integration

of neural systems & conscious regulation of unconscious processes (Davidson & Goleman,

1977; Rieser, 1984; Delmonte, 1987; Loizzo, 2000; Grant & Rainsville, 2005).

In sum, the human mind/brain combines three heterarchical systems of higher

intelligence, each of which works in one of two systems modes: a conservative, egocentric

mode heightening self-preservation and memory; and a generative, altruistic mode

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heightening self-correction and learning (Freud, 1923; Kandel & Schwartz, 1991;

Panksepp, 1998; Fredrickson, 2005). Cultural practices like meditation and psychotherapy

work in part by teaching the self-regulation of shifts in state of consciousness from the

former, reactive mode to the latter, generative mode (Block, 1977; Rieser, 1984; Doidge,

1990; Dietrich, 2003). This shift allows a shift from allostatic drag to allostatic lift,reducing wear-and-tear and enhancing optimization.

Practical Typology & Framework

While these general models and theories of optimizing mind/brain function must remain tentative and will no doubt need modification in light of future research, they provide at least a working basis for another piece of the puzzle. A rate-limiting step for the extension of research to humans and the application of findings to clinical challenges ism incorporating within the global framework a systematic, universal typology of cultural practices that permits their rigorous study and optimal application.

This procedural or clinical dimension of the global framework maps optimization

practices along a biphasic continuum starting with practices that reduce allostatic drag and

culminating in those that promote allostatic lift. Clinical practices meant to help overcome

blocks to optimal allostasis include stress-reduction and conventional dynamic and

cognitive therapies (West, 1987; Loizzo, 2000). Meditative techniques meant to do so

include low arousal practices like mindfulness meditation, TM and Hatha yoga (Wallace et al, 1971; ; Kabat-Zinn et al, 1992; Massion et al, 1995; Telles & Naveen, 1997). One model for these practices is Delmonte’s paradigm that free-association and mindfulness help heal traumatic stress reactivity by reducing cortical dissociation, hence facilitating the analysis of traumatic memories and affect stored in the non-verbal cortex (Delmonte,

1995).

Clinical practices meant to enhance positive factors of optimal allostasis include

alternative psychotherapies like existential, interpersonal and hypnotic therapies, as well as

unconventional forms of psychoanalysis (Loizzo, 2000). Meditative techniques intended to

do so include complex low arousal practices like Zazen and high arousal practices like Tibetan gTum-mo (Lesh, 1970; Benson et al, 1982, 1990; Kim et al, 2005).

One research model for these practices is the self-regulation of euphoric arousal in practitioners of gTum-mo meditation, Sahaja and Kundalini yoga (Benson et al, 1982, 1990; Corby, 1987; Shannahoff-Khalsa & Beckett, 1996).

Based on these assumptions, the global framework includes a comprehensive

typology of optimization practices that dovetails with current brain-based models of stress-

reactivity and learning as well as with traditional Indo-Tibetan models of meditative stress-reduction and learning enrichment (Loizzo, 2000). Informed by comparative evolutionary models of neural structure and function, the brain-based typology classes optimization practices according to whether they reduce stress-reactivity/enhance learning at the neocortical, limbic or core brain level. These are categorized as practices that optimize personal cognitive style, social emotional style and instinctive behavioral style, respectively.

Indic meditative typologies also assume a triune model of neural structure and function and class optimization techniques according to whether they overcome obstructions and enhance mental functioning at the level of individual, social and

instinctive behavior. In the Indo-Tibetan Buddhist tradition, they are viewed as belonging to three vehicles of contemplative life called the personal, social and process vehicles (skt.hinayana, mahayana, vajrayana) and conceived as progressive phases of a continuous pathof self-regulation and optimal human development that begins with psychopathology,moves through normal distress and culminates in an optimal mind/body state described as perfect, complete awakening (samyaksa buddhatva), unobstructed omniscience(anav?ra a-sarvajñ?t?) and unexcelled integration (anuttara-yuganaddha) (Thurman,

Consistent with the consensus of current health psychology and cognitive

neuroscience (Scherwitz et al, 1986; Shulkin et al, 1994), personal contemplative practices aim at overriding the self-referential, worst-case cognitive style that characterizes stress-reactive thinking, and at cultivating a self-critical, open-minded style that supports objectivity and reality-testing.

Examples are practices such as mindfulness, transcendental meditation (stages 1-2) and Hatha Yoga (Patanjali stages 1-4). As with free-association and

mindfulness-based cognitive therapy, the putative mechanism is to override stress-reactive dissociation of verbal processing and to equalize and enhance attention to both verbal and non-verbal processing, supporting the self-regulation and optimization of neocortical-thalamic learning systems of recognition and encoding. Research paradigms here include the findings of alpha coherence, increased cerebral blood flow, dopamine and GABA,increased neocortex, balanced cortical dominance, heightened attention and enhanced perceptual discrimination and problem-solving in mindfulness, TM (1-2) and Hatha yoga(Anand et al, 1961a; Dillbeck, 1982; Brown et al, 1984; Dillbeck & Vesley, 1986; Alexander et al, 1989; Fergusson, 1992; Jella & Shannahoff-Khalsa, 1993; Jevning at al, 1994; Elias et al, 2000; Tooley et al, 2000; Kjaer et al, 2002; Carlson, 2003, 2004; Harinath

et al, 2004; Lazar et al, 2005).



Consistent with current health psychology and affective neuroscience (Rosenkranz

et al, 2003), social contemplative practices aim at overriding the traumatic perceptual-emotional style that characterizes social stress-reactivity, and at cultivating a more trusting,sociable style that supports empathy and collaboration (Dietrich, 2003; Fredrickson, 2005).

Examples are practices such as insight-empathy meditation (Skt. vipasyana, Pali

vipassana), loving kindness (Pali metta), mind-clearing (Tib. blo-byong), Zazen, TM stage

3, Hindu Vedanta and Bhakti Yoga (Patañjali stages 5-6).

As with interpersonal anddialectical behavior therapy, the putative mechanism is to override post-traumatic

reactivity of frontolimbic processing and to equalize and enhance attention to negative and

positive emotional processing, supporting the self-regulation and optimization of

frontolimbic-hypothalamic learning systems of registration and motivation. Research

paradigms include findings of high frequency theta trains, increased dopamine, enhanced

lateral integration of limbic- processing, increased growth of dorsolateral prefrontal cortex

in contemplative insight-compassion meditators (Kazumatsu and Harai, 1966; Lesh, 1970;

Emavardana & Tori, 1997; Easterlin & Cardena, 1998; Gackenbach, 1998; Kubota et al,

2001; Walde et al, 2004; Grant & Rainville, 2005; Lutz et al 2004) as well as the long-term

prosocial change in personality style in euphoric TLE (Persinger, 1984, 1993; Bear et al,

1985; Fieve, 1997).

Consistent with current health psychology and behavioral neuroscience (Shulkin et

al, 1994; Mattson et al, 2002), instinctive contemplative practices aim at overriding the

fight-flight response style that characterizes behavioral stress-reactivity, and at cultivating

a disarming, love-growth response style that supports nurturance and creativity (Dietrich,

2003; Fredrickson, 2005). Examples are practices such as optimal integral process (Skt.



anuttarayogatantra), kindling (Skt. candali Tib. gtum-mo), TM Siddhi (stage 4-5), Ananda

Marga, Sahaja Yoga, Kundalini Yoga (Patañjali stages 7-8) and Qi-gong. As with imagery

therapies and visualization-and-breath-based self-healing (Loizzo et al, 2006), the putative

mechanism is to override the instinctive stress reactivity of the core brain and to enhance

attentional control of fight-flight and love-growth responses, supporting self-regulation and

optimization of extrapyramidal-basal ganglia learning systems, i.e. rehearsal and

commitment. Research findings include fast beta or gamma frequencies in the EEG,

increases in endorphins, dopamine and arginine vasopressin, melatonin and DHEA, a

paradoxical pattern of high CNS arousal and muscular relaxation similar to REM sleep and

sexual response, a “heart-brain prep” pattern of centrally shunted blood flow and slowed

metabolism resembling that of hibernating, estivating and diving mammals (Das &

Gastaut, 1955; Anand et al, 1961a, 1961b; Hoenig, 1968; Kothari et al, 1973a, 1973b;

Corby et al, 1978; Benson et al, 1982, 1990; O’Halloran et al, 1985; Jedrczak et al, 1986;

Heller et al, 1987; Selvamurthy at al, 1988; Lui et al, 1990; Glaser et al, 1992; Shanhoff-

Kalsa & Beckett, 1996; Infante et al, 1998;Young & Taylor, 1998; Jones, 2001; Myamura

et al, 2002; Kjaer et al, 2002; Lutz et al, 2004).

Future Prospects for Research & Application

Given the interest all humans have in aging slowly and well, and given the primary

role mental capacity plays in quality of life, the importance of the topics addressed in this

panel should be clear. Also clear from even a cursory review of the field is that this is a

very exciting time for longevity research, when pessimistic assumptions are being

challenged by very encouraging findings in many areas. As if current research were not

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promising enough, this conference draws attention to the exciting possibility that a rapidly

advancing new science may be even further accelerated by contact with a time-tested non-

Western scientific tradition of promoting longevity and optimization. The very fact that

this may be true raises a number of complex issues of methodology that prudence requires

us to address, however briefly. Since these issues have been explored in prior panels on

methodology and scholarship, I trust it will suffice to say that the distance in theories and

methods between Western physical science and Indo-Tibetan meditative science is not as

great as that between Western science and Western religious contemplation. Instead, it is

closer to the distance between quantitative, physical science disciplines like neuroscience

and qualitative, intersubjective disciplines like hypnosis and psychotherapy (West, 1987;

Loizzo & Blackhall, 1998; Loizzo, 2000; Grant & Rainville, 2005). Further, the existence

of a time-tested and comprehensive tradition of mind/body theories and practices to

optimize longevity and mental capacity has enormous potential for speeding the work of

basic research and clinical application (Alexander et al, 1989; Thurman, 1995; Bushell,

On the basic science side, a cohort of systematically trained virtuoso subjects

promises to facilitate human studies of the mechanism and scope of self-regulation of

aging and mental capacity. On the clinical side, a comprehensive array of traditional

methods for teaching contemplative theories and practices for longevity and optimal

mental function to experts and the general public raises the possibility of more effective,

reproducible interventions in complementary medicine, mind/body medicine, public health

and education (Shapiro et al, 1998; Coker, 1999; Loizzo, 2000; Loizzo & Blackhall, 2001;

Weber et al, 2002; Walde et al, 2004; Loizzo et al, 2006). In particular, the Tibetan

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tradition is unique in preserving what may be the world’s most rigorous and

comprehensive systems for optimizing mental functioning as well as quality of living,

aging and dying. Most intriguing is the fact that these systems include ways of teaching a

variety of individuals of different inclinations and temperaments a variety of methods

suited to a variety of sustainable lifestyles (Thurman, 1995; Loizzo, 2000). Critical to

advancing this work is the adoption of a global, multi-disciplinary framework integrating

basic and clinical researchers in a wide range of fields with virtuoso practitioners and

scholars, clinicians and interventionists.

Beyond complementary medicine, another key area of where a global, systematic

approach to research and application is needed is business. Understanding and replicating

the optimization of mental function under stress would have obvious benefits for workers

and businesses caught in the structural tension between ever-rising expectations and ever-

mounting demands. Intersecting with optimizing health and well-being, optimizing mental

functioning at work has cognitive, affective and behavioral dimensions and involves the

whole range from stress-protection to enrichment of mental function. The limitations of

disease-management programs and personal coaching have become clear in recent research

and appear to overlap with those of conventional medicine and psychotherapy. A more

radical, complex and complete approach to the rate-limiting internal variables limiting

allostasis and optimal functioning promises to have greater impact on presenteesim, stress-

hardiness, motivation and productivity, commensurate with that seen in meditative

approaches to health. A whole new avenue of human studies is indicated here, and is

something we are pursing at Cornell.

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Finally, perhaps the most obvious application of research on optimization relates to

education. In almost all areas of American education, the philosophy and direction of

change is not just uninformed by current science but at odds with it. The trend towards

uniform standards, standardized testing and narrowing of academic aims and methods fliesin the face of recent findings on the genetic and acquired variability in learning, thedetriments of stress and the benefits of positive affect, and the sensitivity of learning tosocial and cultural environment.

Here too the existence of time-tested Indic traditions ofcontemplative learning, as preserved in Tibetan Buddhist monastic colleges, offers an invaluable paradigm for bringing Western education more in line with the contemporary science on learning, including optimization (Travis, 1979; Aron et al, 1981; Shapiro et al,1998; Tloczynski et al, 1998).

As the most fully elaborated and preserved form of the

ancient Buddhist academic tradition, the Tibetan curriculum offers a time-capsule of the

classical world’s most optimization-friendly approach to universal education (HH Dalai

Lama, 1995; Thurman, 1995).

In sum, contemporary research on aging holds out real promise for the preservation

and optimization of mental function throughout the lifespan. Equally compelling, the

growing collaboration between Western and Indo-Tibetan mind science shows real

promise for the acceleration of advancement in this area of vital importance to us all.

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