The Neuroscience of Emotions by Dr. Phillippe Goldin (Full Transcript)

And just to be really clear, the intention for today is to give you a brief introduction to a little bit about what we understand about the neuroscience and how the brain works with respect to emotions, emotion regulation, emotion intelligence.

But it’ll be brief because we only have a short time. And this obviously — We should start with some history.

History

So, Darwin, speaking about emotions, made it very clear that animals need emotions to survive. So do we. They need fear as a trigger to escape predators, and aggression to defend their territory, their young, and food.

Emotions– He believed that emotions are really maintained from our animal past in the trajectory of evolution of human animals. And that we really rely on different emotions in different ways to make quick, often complex, decisions.

So why do we have emotions?

As you can see here, just looking at this photograph, just notice where your attention goes. Notice what you see. So, from multiple decades of research on emotions, we know that there are several functions. One way–emotions help to direct our attention. It helps to enhance our memory and how we actually encode and consolidate different pieces of information. Especially for information that’s personally salient.

It also helps us to organize our behavior and our orientation towards other people. Specifically how we drive– It helps to drive and direct social approach or even social avoidance. And, probably most importantly for this group, and for the course– the Search Inside Yourself course, is that different emotions and the way our learning history with emotions really helps to develop moral and ethical behavior.

When emotions — and the brain is functioning well, it can be an incredibly adaptive system, meaning that emotions bring richness to our experience, how we interact with people, how we interact with ourselves.

When emotions are dysregulated, out of control, exaggerated, this can lead to things like anxiety, depression, burn-out, even suicide. So this is really a very important aspect of the human experience.

Classes of emotion

There are different classes of emotion. So, researchers have talked about six primary or basic emotions. They are happiness– as you can see– Happiness, surprise, fear, sadness, disgust, and anger. And you can check your own experience as we go through this talk to see how this aligns with what you’ve experienced in yourself.

There’s also kind of a background sense of emotion or mood– Moods are long-term, emotions are more punctate or short, acute. So they talk often about wellbeing versus malaise. A sense of calm versus a sense of tension. Feelings of pain, emotional and physical, in contrast to pleasure.

And then, importantly, especially for social animals like human beings, all of us, there’s a whole other realm of social emotions that are in contrast to the primary. And this really has to do with interpersonal interaction, so emotions that arise like embarrassment, jealousy, guilt, shame, sense of pride. So this is a rough sketch of the different kinds of emotions.

Now, emotions are obviously expressed. One of the most powerful, ubiquitous ways is through our facial expressions. So these are the six primary emotions and the facial expressions of those emotions. As you can see. And apparently, in the English language, there are over 600 words to describe different emotions, and on your face there are 42 different muscles that work together to express, very subtly, different emotional expressions.

And Paul Ekman from U.C. San Francisco, emeritus professor, actually came up with a facial action coding system to actually delineate what muscle groups need to arise in order to make different emotional expressions. So there’s a whole science behind all of this. It’s not only an American or a North American emotional expression thing. In fact, lots of research by Paul Ekman and other people have shown that the identification of different facial expressions is cross-cultural, as you can see, and there’s a very high rate of consensus across different cultures, different backgrounds, about what constitutes happiness, sadness, disgust, and so forth.

Another very important purpose for studying emotions is that emotions are truly, if you think about it, and check your own experience– are an important source of information and feedback that help to direct our behavior and also our social interactions.

So you can think, how often do we use a gut feeling or a gut instinct or kind of an intuition to make a quick decision? And, in fact, I would suggest that if you check your experience, this is happening many times per day. So emotions are really contributing to cognitive processes. Thinking, reasoning, decision making.

Now, we know that here, in the brain, when a person has a lesion, right, the absence of a– be it a tumor or some kind of disease, we know that frontal lobe lesions often result in impaired emotional awareness. Which goes along with impairment in social reasoning or interpersonal problems, and also problems making decisions.

So we know that there’s a direct connection between the functions of brain systems and different aspects of emotion and their sequelli. Emotions really exist on a range. I’m stating the obvious. From a normal sense of emotions, and then the extreme forms of those emotions. So I would posit that sadness, which is a very normal human experience, in its extreme, can lead to major depression. Can be a very important component of major depression.

Anger, which also is a very normal human emotion, when it reaches an extreme or an exaggerated form, can become unprovoked aggression. An angry orientation in all of our social interactions. Pleasure. Again, normal. In its extreme, it can lead to addiction. Fear, which of course, is appropriate in dangerous situations as a protective mechanism, in its exaggerated form, can lead to anxiety, different kinds of phobias, even panic attacks or panic disorder.

And worry, in itself, when it’s out of control, and when it’s extreme, can lead to generalized anxiety disorder. So we can really appreciate that the emotions shift and move along a continuum from normal to extreme.

Emotion and the brain

Well, we know when people have different emotions it manifests in brain circuitry. And specifically, different functional areas. In this case, really the focus over the past several decades has been on the emotion-related brain circuitry in the limbic system, which is really a distributed set of brain nodes or brain regions that function together to have the experience of emotions, and maybe even to generate emotion experience. And to detect what’s personally salient and emotionally significant for us.

So this is happening in a distributed brain system. What you see here in bright red is the amygdala, the left and right amygdala, which is, as probably everyone here knows, is a very important node within this limbic system for emotions.

Here, just to flesh it out a little more, the limbic system really is made up of multiple brain areas, including the amygdala, hippocampus, hypothalamus, and other brain regions. And even other paralimbic regions like the orbital frontal cortex. So we’re only beginning to really understand how these different brain circuitries contribute to different kinds of emotion and the ability to work with our emotions.

How do we actually measure emotion?

So, having said that, how do we actually measure emotion? Well, many, many different ways.

One way, as you see here, is actually taking first-person, subjective emotion experience from moment to moment to moment. Here you can see it’s actually oscillating from neutral to amused to sad, and this is being induced by watching film clips. So this is subjective emotion experience. First-person report. That’s one window into emotion.

Another way is using peripheral autonomic psychophysiology. Skin conductants, facial muscle contractions, heart rate, breathing rate– These are all autonomic psychophysiological measures that we can use.

Another way is literally looking at facial expressions. Of fear, for example. Another method is — which I will be talking about– is functional neuroimaging. Using, for example, brain imaging techniques to look at an index of neural activity.

Here it’s shown as bilateral amygdala. And then another method that’s relatively– Well, no, actually it’s been used for several decades– is literally putting a grid of electrodes right on the cortex to measure under the skull. And of course, this is an invasive procedure, so it’s only done, you know, during epilepsy. It’s not done to study emotions by itself. Not to worry.

Brain imaging techniques like fMRI, which I’ll talk about, is wonderful because we can go under the skull noninvasively. No harm. Just to drive home the point, when we talk about different emotions, this is one study we did where we had neutral, sad, and amusing film clips. Brain imaging, fMRI signal, what’s called “BOLD,” the blood oxygen level dependence signal.

First-person emotion ratings from moment to moment, heart rate, and then breathing rate or breathing intensity. And this is just to really make the point that this is a dynamic, interactive system. And this is only four channels. There are many other channels that we often look at– can look at as well. A full explanation of a phenomena would really go from looking at the genes or genetic contribution, to molecules, to neurons, neural circuitry, and then how different cognitive processes– thinking, decision making, emotion, behavior– are instantiated in those neural circuitry.

For today’s talk, I’m only going to be talking about the top two. But a full explanation really is from genetics all the way up to interpersonal interactions. And currently we have the technology to look at all of that. Many different modalities of functional brain imaging. There are many different tools. They all have their pros and cons, strengths and weaknesses.

What we’ll be looking at is– in the black box is referring to the orange circle– is fMRI, functional magnetic resonance imaging. So that gives us a signal on the order of seconds across the entire brain, and approximately we get the unit that we can analyze. It’s approximately two-three millimeters of voxels. So it has its pros and cons, but it’s noninvasive, and that’s what we use.

Now, if no one here is– If you’ve not been in an MRI machine, essentially it’s a magnet. And it’s a beautiful, elegant machine, but it’s a magnet. And you can see that people are lying down on their back and we put them inside the bore of the magnet. And I’m going to give you a one-slide primer on the dependent variable in fMRI.

So you’re lying in the scanner, you have this angry, harsh, critical face, presented to you, you’re perceiving it. This sets off firing in specific populations of neurons that activate neural circuitry– distributed neural circuits– that then are consuming glucose and oxygen, send a signal downstream– “Hey, the neurons are firing,” send more cerebral blood volume, more blood flow, and specifically, more oxygenated hemoglobin and, glucose. So that the neurons can continue to fire and you can replenish what’s been used.

Then they do a lot of signal processing and statistics to create brain maps, which you’ve seen in magazines, I’m sure, to actually infer the underlying neural activity that’s occurring in response to looking at an angry face. And then we use functional– our knowledge of functional neural anatomy to try to infer what these different brain systems are doing in conjunction with specific experimental design to tease out the function of different brain activity. That’s a one-slide primer.

So, there are many ways to probe the brain. And specifically to look at the emotion-related brain regions in the limbic system. One way would be dynamic social feedback, so you can imagine a person in a video clip looking at you, going, “People don’t really like you.” That’s one method. Especially for people who are socially sensitive.

You could also use music. Studies have used both positive and really sad music to induce very rapid shifts in emotional state. And you can just check your own experience listening to different songs– Bruce Springsteen songs or whatever.

Another way as we’ve already shown is facial expressions, because we are super sensitive to the slightest shifts, whether we’re aware of it or not, in peoples’ facial expressions. Electric shock. A very powerful–especially the anticipation of the shock, even if you don’t deliver a shock, sets up all kinds of anxiety and fear and defensive responses that you can begin to measure in the brain.

Another method that’s closer to what we do in psychotherapy or clinical practice is peoples’ own negative self-beliefs. So, for example, “something is wrong with me.” Having that thought spinning in the mind can actually induce activity in the limbic system, and is really the basis of what we begin to work with in, — for people with depression and anxiety.

What are the core negative beliefs? So these are–this is just a sampling of different methods that can be used to probe the function of the limbic system. But then there’s a whole other part. This beautiful prefrontal cortex that is so fully developed in the human animals, which allows us to take perspective.

To think, to analyze, to use language. All in the service of emotion regulation. In what ways can we actually think in a certain way that helps to change the meaning of something that’s going on right now in our life. Or even right this moment. To change its intensity, to change its duration. To even shift our interpretation of what that emotion is doing and why we’re having it. That’s this prefrontal cortical area that allows us to make abstractions, think, take perspective, apply different strategies. But this is not new.

Almost two millennia ago, Marcus Aurelius said, “If you are distressed by anything external, or even internal, the pain is not due to the thing itself, but to your estimate of it, and this you have the power to revoke at any moment.” Profound, profound statement. Definition of emotion regulation. So it’s not a new phenomenon in human animals, it’s been here for thousands of years. But this is really something specific about our prefrontal cortex that allows us to work with these processes to modify our experience from moment to moment.

So, there are different stages of emotion regulation. And just, as I’m saying this, check your own experience. Pre-conscious. Are there proclivities or even cognioprocesses that are happening in the brain when a situation is occurring even before we are aware of it that’s influencing how we interpret our emotions, how we interpret our current situation? Then this leads to immediate attentional shifts when it bursts into conscious processing– Something scary is going on. There’s threat. Do I shift my attention to the source of threat? Social approach. Do I shift my attention away? Avoidance. Both of which are forms– can be forms of regulating my attention, and which thereby influences emotions.

Another aspect is emotion appraisal. How do I label that emotion? How do I interpret what that emotion is? And then cognitive reappraisal. Using our thinking and perspective-taking ability to change the meaning. “Oh, that’s not a source of threat, it’s only a stick or a rope, it’s not a snake.” “Oh, that person was only– was looking at somebody else, Not at me.”

And then finally, and more subtly, meta-cognitive. How I view how I process thinking. How I view my ability to create a space to understand how my mind works. So more meta-cognitive processes, which can– All of these things that we’re talking here can be trained. Through different practices.

Neuroanatomy

Little bit about the neuroanatomy. Some wonderful work by Mary Phillips, Helen Mayburg, Wayne Drevets, Kevin Ochsner, on and on and on. Some fantastic neuroscientists who really have, in the past 10-15 years, begun to create models– brain anatomy and functional anatomy models of emotion reactivity and regulation.

So in the context of a threat, real or imagined, this can rapidly shift our affective state. Fear, anxiety, arousal. And this is really embedded in the emotional reactivity in the limbic system. Amygdala. Anterior Cingulate. This sends a bottom-up signal to recruit help from other parts of the brain, other brain systems.

When that’s working correctly, then in blue, see here that there are regulatory systems that then begin to process what is that threat? What are some strategies? How can I work with it? And when it’s working well, it sends a top-down signal to modulate the intensity, the duration, the interpretation of that ongoing emotion experience.

But I would also add that especially in human beings, this is mediated through our view of self, be it positive or negative or otherwise, and our ability to use language and thinking to modulate and understand our experiences. So this is a beginning of a complex system that people are beginning to examine using all kinds of neuroscientific tools.

Emotional intelligence

Terms of emotional intelligence, which is a relatively new concept. Peter Salovey and John Mayer have defined it in the following way…it is the ability to monitor one’s own and others’ feelings and emotions, to discriminate among them, and to use this information to guide one’s thinking and actions in a way that is not harming, and hopefully helping, others and self. So this is very fundamental to human social interaction, human systems, Google, the world.

But this really relies on previous work by Howard Gardner, who had a very, very influential book where he talked about multiple intelligences. So in cognitive psychology, clinical psychology, we often talk about IQ. Intellectual cognitive abilities. But of course, there are many other kinds of intelligences which are as important, and in some situations even more important, in the domains of interpersonal skills and intelligence, and also intrapersonal skills.

So the idea is that there are multiple forms of intelligence, and that these are important to develop volitionally, intentionally, and to find methods to actually work on that, to become a more full, skillful, optimal human being.

Some of the skills and competencies that we’re thinking about, especially in Search Inside Yourself…Emotional awareness. The inverse of that is alexithymia – the inability to detect and even describe one’s own emotional states, let alone others’. Mindfulness – the ability to volitionally place one’s attention in the moment on purpose from moment to moment without negative critical self-judgment. Self-awareness – enriching and enhancing our understanding of what actually– who actually am I? How do I function? And the ability to regulate.

When I am off-balance, do I know how to regulate and bring myself back into balance? Off-balance, back into balance. That’s a whole set of skills. Motivation. What’s the motivation or intention for engaging in action? Behavior? Interactions with other people? Empathy. As we’ll see in a moment, the ability to actually tune in and feel the reverberation, so to speak, of the emotional state of another person. Dropping the self just enough to attend to someone else in deeper and deeper ways. And then social skills. Both linguistic, language, body language, even vocabulary. And also just being able to evaluate and take feedback.

So all of these are in the service of enhancing psychological flexibility and well-being. So, I did a lit search, and there are not that many studies on emotional intelligence and brain functioning. But one that caught my eye is the following, which is done by Killgore and colleagues. In this particular study they worked with 16 healthy children and adolescents, and they had to do processing of fear facial expressions.

Here’s one example. So, fear face expressions. Processing those. What they found is on one of many emotional intelligence questionnaires, the more emotionally intelligent via self-report questionnaire that these kids demonstrated– this was associated with a reduction–blue– a reduction in brain activity in a distributed set of brain systems that had to do with somatic or sensory experience, emotion reactivity, and even kind of cognitive control.

So reduction in the need to try to control to viscerally feel, and–in red– enhanced activity in some of the visual processing areas as a function of reporting greater emotional intelligence. So this is one study, but it’s very promising to see even in a younger sample of children that emotional intelligence have correlates in the brain that are interpretable and important in terms of emotion and sensory experience.

Empathy

So, I said that we’d talk a little bit about empathy. So, currently, it’s a hot field. It’s a hot area within neuroscience. A decade ago, no one would’ve touched this. So this is really talking about a paradigm shift among scientists who, by definition, tend to be rather conservative in what we study, but understanding that we now have the tools to be able to begin to dissect, deconstruct, manipulate levels of empathy.

So here, we can under– how can we understand the other person’s mind? You can say theory of mind is one aspect of this. And what is the neurocircuitry involved? So, empathy, I would say, really relies on a bunch of earlier developed skills, in fact, some that are innate.

So, what I’m putting here is a picture that shows that children, infants actually can imitate imitation, facial expressions, and motor movements in adults. This is a very important clue. So now we’re becoming detectives. The ability to perceive others and to imitate their behaviors is a building block for empathy. In fact, some studies have shown that there’s a frontal cortex to parietal network that’s implicated in mirror neuron systems for the ability to perceive others and to imitate their behaviors and their actions.

So when you see kids, for example, sticking their tongues at each other, there’s in fact a brain network– the yellow part has to do with visual information feeding the red– the two red areas that have to do with generating the motor pattern and then understanding how my motor pattern matches what another person is doing.

Observation of an action automatically triggers simulation of that action in the brain. Even if it’s not expressed. Premotor cortical neurons fire during goal-directed actions as well as during observation of similar actions. So throughout the day, as we observe others, parts of our brain are actually setting up simulations that mirror other peoples’ behaviors. And we’ll say that the neural bases of imitation, as shown here, is really a basis for empathy, which, in one way, is an inner imitation of the emotional state of another person.

So we actually have the neural bases that we can begin to probe and see how they change with training. So empathy here can be construed as identification with and understanding of another’s situation, feelings, motives, intentions. The state of being in tune with another person, particularly by feeling what their situation is like from the inside. Not just intellectually.

And empathy– this is interesting– may or may not precede sympathy, which is a basis for developing the ability to cognitively understand that person’s mind, how they view things. So empathy would be more an affective state. In fact, this is shown here. One study that had to do with looking at empathy for another person’s pain. Physical pain, emotional pain, triggers in the perceiver, shown here, brain regions associated with emotion processing.

Visceral experience

Bilateral insula, a very important area that has to do with the visceral experience when you see someone else in pain. In this particular study, people viewed short film clips of people who either were neutral– not–affectively are not in pain– versus people who are in a very painful response. Imagined the feelings of the other person or even oneself having that pain. And here, what I just want to point out, is that, they measured two things. Personal distress and empathic concern. And what you’ll see is the empathic concern was much greater when you saw the other person in pain. Not oneself. The personal distress was greater when you imagined yourself in pain, not the other.

So here, this is a double– this is a double dissociation where we can actually begin to delineate different aspects of empathy, and where they’re playing out in the brain. And again, insula– insular cortex, this visceral experience of pain in others. So this starts to get exciting, in fact.

Another very important review paper came out recently, by Chaim and Tanya Singer, trying to delineate two different aspects. Cognitive perspective taking, which is something that we probably are all doing many times a day trying to understand what other people are thinking. The ability to understand intentions, desires, and beliefs of another person, resulting from cognitively reasoning about the other’s state. “How is this person seeing the situation?” “How could they actually do problem solving?” “What are the things that they– “are important in their process in decision making that lead to their behavior?”

In contrast to that, the empathy is really getting into the affective state, which is caused by the sharing of the emotions and the sensory experience of another person. Dropping the self just enough to begin to experience the emotions of another person at least to some degree. On some level.

So these two different perspectives on how to understand another person. Green and orange are actually mapped onto different parts of the brain. And that the cognitive has to do with more medial prefrontal cortex, higher order abstract mental representations of the other, as well as taking– actually, areas that have to do with social cognition, perspective taking, how I represent other people in my mind. Versus the orange, which has to do with the anterior cingulate and, again, the insula, which has more to do with trying to resolve conflict. Actually experience the visceral state of another person’s emotion. So there’s kind of tuning in on an emotional level. So the brain is actually showing this even without people’s first-person report. So this is a very interesting way that the brain imaging is leading to understanding about how people are functioning that we may or may not be able to verbally express or always reliably express verbally, I should say – compassion.

So I would suggest– and this can be open to debate and thinking. Empathy, the cognitive perspective taking, are building blocks. Both are necessary for developing compassion. Compassion being truly– well, I’ll let the definition come up. The deep awareness of the suffering of another person coupled with the wish, the intention, the motivation to relieve that person from their suffering. So it’s both an emotional component and a cognitive component.

A tender feeling. Sympathetic, sad concern for someone in misfortune. Pity for others with a desire to help. And I would pause it here and bold that empathy and cognitive perspective taking and behavioral action is really the crux of compassion. And this can be trained. So it’s the emotion, the cognition, and the action to relieve others of suffering.

Compassion doesn’t mean we have to become angelic. Angels. And I put this up here because that’s actually an obstacle to even thinking about, “How can I become more compassionate at work, at home, in my relationships?” If a goal is too lofty, I’ll stop from the beginning. This is not the case.

The absence of compassion can lead to incredible…painful…decisions to abuse other people. As we see in Abu Ghraib in this picture. But also, in this same field in the theater of war, there can be moments of compassion where a person decides to pause enough for a moment to connect with others. So this is really important. This is not just theoretical. This is actually playing out from moment to moment either in very safe environments like Google or Mountain View or in very dangerous environments like East Palo Alto or Iraq or Afghanistan and everywhere in between. So this is not theoretical. This is actually fundamental.

In fact, one quote here. “I feel the capacity to care is the thing which gives life its deepest significance.” His Holiness the Dalai Lama says, “Love and compassion are necessities, not luxuries.” Why? Because, “Without them humanity cannot survive.” And I think that one reason that neuroscientists, neurologists, psychiatrists, psychologists, researchers, even physicists at Stanford, neurosurgeons, and beyond are actively putting their intellectual resources, their money, and their time into studying this.

Why? Because they realize that this is getting pretty serious. It’s not a luxury. It’s a necessity for human animals to continue to exist on this planet. So that’s why the neuroscientists who wouldn’t have touched this ten years ago, are actively studying this now because now we need to do more and we can do more.

In fact, what do people at Google say? The Googlers say, “Don’t be evil.” How wonderful. At least do not harm others. And if you can, if possible, bring some benefit to others. So I like your motto.

EEG, another imaging tool. Different capacities. Can we look at people who worked on training their minds? Well, the answer is yes. When people are doing loving-kindness meditation, which is one kind of compassion meditation practice, there are specific parts of the brain from which we can begin to measure rapid electrical firing patterns that show when an adept, a really well trained meditator in this case– but it could be a chess player, it could be a mathematician, could be an engineer, could be a therapist– can invoke a state of mind that’s open to loving-kindness towards all beings.

And how does that manifest in these electrical patterns in the brain? Well, in fact, we can begin to delineate that. Can we train it? And that brings the last part of this talk. The most inspiring part, I hope. Neuroplasticity.

Neuroplasticity

So until recently we thought, you can’t change the brain. You can’t change the anatomy. You can’t change the functioning or the linking of circuitry. Well, in fact, we’re finding more and more that you can. So until recently they thought, “Okay, so maybe when you’re infants, the brain is plastic. But as you become adolescent and adult, you cannot.” That also now has been debunked. And in fact, training the brain– training influences brain structure and brain function.

Here we go. This is a very, very simple engineering diagram of the brain. Very simple. The brain is super– What is it? Google actually refers to ten to the hundredth, right? That’s what a google is. I looked it up. I would posit that the brain is that complex. We are only presenting reduced reductionistic aspects of the brain. The brain is much more complex and beautiful than we can imagine.

But we know from our own experience, and I hope this is true, that in our own mental states can be like a fly stuck on sundew leaves. Stuck, not able to fly. And at other times, via our own experience, we can experience our own mind as a fluid mountain stream. And I would posit that it’s about our choice. We can train the mind in either of these directions. We can also bring a sense of acceptance to both of these mental states in our self and others.

So what’s the evidence from neuroscience?

Well, for people who have Obsessive Compulsive Disorder, a study now ten years ago– a decade ago– looked at the orbital frontal cortex right up behind the eyes and actually found that a part of the baseline you could actually predict based on your metabolism of glucose in that part of the orbital frontal cortex. Predicted who would respond to both medications and to behavioral therapy. This was a very important study. A groundbreaking study that could show brain functioning can predict who will benefit from at least two very different forms of clinical treatment in people with Obsessive Compulsive Disorder. Very exciting.

Fast forward. Now three years ago, Chris deCharms, formerly at Stanford, did a fantastic study looking at– showing people in the MRI scanner a little igloo with a fire. The greater the fire, the greater the neural activity in a specific part of the brain. This part of the brain. And he had people up and down regulate from moment to moment their own brain activity. And it was represented by the flame inside of an igloo for people with chronic physical, emotional pain, and show them that they could actually up and down regulate activity in a specific part of the brain. That’s neuroplasticity in a clinical intervention for people with chronic pain using what’s called real-time fMRI. This is one of my favorite studies.

London cabbie drivers. Cab drivers. Showing that the number of years of experience driving in London, which apparently is an incredibly complex grid, not like New York City, that they actually had greater activity in the hippocampus. On a struc –I’m sorry. Structural changes in the structure of the hippocampus based on the numbers of years of experience driving a cab in London. Direct experience literally changing the shape of the anatomy of the brain. Again, neuroplasticity.

These are examples. Specific phobia showing that cognitive-behavioral therapy, which is the gold standard psychotherapy for most of the — actually, all the anxiety disorders and this specific phobia being one kind. Showing that from pre to post cognitive-behavioral therapy, activity in the –whoops. Here shown in the anterior cingulate and also in bilateral insula was reduced following cognitive-behavioral therapy. So people’s cognitive conflict — and also their visceral emotional reactivity reduced in the presence of the phobic stimulus from pre to post cognitive-behavioral therapy.

Here’s just another study about actually what we’re doing. This is preliminary evidence showing that for people with social anxiety disorder, when working with your own negative self-beliefs, pre-post 16 sessions of cognitive-behavioral therapy for social anxiety. Red here means increased activity in areas having to do with self-regulation, access to linguistic processing, and then attention and cognitive regulation increases in people when they’re working with their own negative beliefs pre to post cognitive therapy. This is a very interesting study that was done cross-sectionally. Not pre-post, but looking at insight meditation practitioners. That on an anatomical level, these two areas, which normally decline as you age– this is gray matter — normally decline as you age, which actually was preserved in those people who meditated.

And in fact, the number of years of meditation was shown to protect– was a protective mechanism– against the normal decay or loss or degeneration of gray matter. Cross-sectional study. Not pre-post. So it’s a different kind of design. But I’m sure that somebody will be working on stronger experimental designs soon. So again, more evidence that how what we choose to do with our time influences even across the aging process. And this is just another study showing that with mindfulness meditation in people with anxiety disorders — in these circles is a network of brain regions in which attention regulation is instantiated and that those regions are increased – i.e. better ability to use the brain to shift your attention pre-post mindfulness training.

And even before, I said about the self. We also have preliminary evidence that’s now in at least two different labs or three different labs for people with anxiety disorders or even depression, that the neural network that supports cell-focused attention can actually be modulated with attention training. Mindfulness meditation training.

So in summary — threat, real or imagined? Definitely we can see is that you can modulate up or down — but hopefully down– the intensity of emotional reactivity. And that you can use all of these other brain systems. Cognitive regulation, thinking, attention regulation. They’re eventually shifting our awareness and our attention mediated through self-view and language to lead to greater well-being. I have done this work with many, many other people. These people are in my group. And many others who aren’t even in the picture here. And this is where I am virtually. I’m actually right here. And thank you for your attention.

Chade-Meng Tan – Owner, Search Inside Yourself Program

We have about ten minutes for questions and answers.

Philippe Goldin – Head, CAAN, Stanford University

Maybe only questions?

Question & Answer Session

Chade-Meng Tan: Any questions?

Philippe Goldin: Are any of you pondering? It doesn’t even have to be a question. A reflection.

Question1: Sorry, just wondering will these slides be posted? Will we have access to these?

Philippe Goldin: The whole talk is going to be uploaded to YouTube in its entirety.

Questioner1: Okay, thank you.

Philippe Goldin: So you can ponder it even more.

Questioner2: Would you be able to go back to the study on the adolescents and—

Philippe Goldin: Yes.

Questioner2: Just go– I wasn’t sure.

[Question inaudible] No, grown up. Because it seemed like you were saying something that to me seemed contradictory but maybe it was just– I was misunderstanding.

Philippe Goldin: Okay, so here– this is one study. One thing I want to make very clear is don’t trust one study. Trust the meta analyses or trust a study that’s been replicated at least once, preferably twice, not in the same lab. That’s one thing that’s a caveat in science. Don’t trust any one study.

Here, this is one study with 16 children and adolescents. So already that’s kind of a wide range. But supposedly what we’ve presented in the study is that the greater– by self-report on a questionnaire– the greater the emotional intelligence score reported by kids and adolescents, the reduction–blue– in these regions and other regions that have to do with emotional reactivity, visceral response to fear faces.

Questioner2: Specifically to fear faces?

Philippe Goldin: Yeah, this is just one example. This is to fear facial expressions. And people — the human brain is super sensitive to facial expressions of fear, anger, and have a reliable neural response.

Questioner2: Okay, thanks.

Philippe Goldin: But it is interesting. What exactly — So this is a very kind of course. What aspect of emotional intelligence relates to less emotional reactivity to fear? That was not answered.

Questioner2: Right.

Philippe Goldin: That’s why you need further studies. Is that only in the adolescents or is it in younger kids? Is it age dependent? In fact, another study that I don’t think is published yet from our group, James Gross’s lab at Stanford Psychophysiology Laboratory, looking at the eight-year olds up to 22-year olds — boys and girls, every single age– the ability to use thinking, re-interpretation strategies, i.e. cognitive regulation or cognitive reappraisal — in clinical, we say cognitive restructuring– to emotional probe, to emotional reactivity, was actually predicted by cognitive development. Which totally makes sense.

So the older you are, the more cognitively developed. The more cognitive development you demonstrate on neuropsychological tests, the more you’re able to use cognitive reappraisal strategies to down regulate emotional reactivity. So there is an age-dependent thing from at least 8 to 22. But then it raises the question, from 22 onwards–70, 80, 90– what are we doing? Can we train? Can we overcome anger? Can we overcome low self-esteem? Can we overcome insecurity? And how? And what are the best methods? Yeah, so I think there’s somebody behind you.

Questioner3: S.I.Y.

Philippe Goldin: S.I.Y. Search Inside Yourself. One method to do that or at least to begin to try to do that.

Questioner3: I’m just wondering if there’s any consensus among the critics or skepticism around this work that might be– that we might be able to address as well?

Philippe Goldin: Does any– I mean, I have my own skepticism. Are you– Is there something in your mind that’s come up?

Questioner3: No, no, no, I don’t. In fact, this is all very new and very exciting.

Philippe Goldin: Yeah, sure. I’m happy to– You know, one of the great things about being in science is that we can be skeptical professionally. So I have my skepticism in the following way. I’ll try to just briefly– So for example, in cognitive-behavioral therapy, which I’m trained in, it’s change oriented. Identifying mistakes in thinking. Thinking in ways that are actually harmful, not beneficial, that lead to feeling worse about myself or others. One method to work with that is to identify those thoughts, modify them, change them, deconstruct them, find evidence that those thoughts are either not accurate or that they’re not beneficial. So that’s really a heady, logical, linguistic, language approach. Shift. I’m also trained in mindfulness or in meditation. Different kinds of meditation techniques. One of which is mindfulness meditation. There, you go for change, but it’s not language based, it’s not linguistic, it’s not cognitively challenging my thoughts. It’s actually shifting how I approach my own experience. Radically different from the cognitive-behavioral approach. But probably leading to the same kind of psychological flexibility. Currently people are —

How do we know when someone walks in the door or even a friend, what methods work best for whom? We actually don’t know that. How do know that a combined approach would work best for Joe or for Sally? Currently, we actually don’t know. And this is one of the biggest problems. If I train you in certain skills where I assume this is going to be helpful for you when they’re not, we’ve just wasted energy, time, money, even actually inducing more frustration. So for example, meditation is not good for everybody. We know that as a fact. Cognitive-behavioral therapy doesn’t treat everyone’s anxiety or depression 100%. We know that as well. What’s in the 30% that don’t get better? How can we figure out who will get better? Yeah, yeah, okay.

I mean, I have many more questions and doubts but that’s at least one of them I can share. Yeah.

Questioner4: You just listed off two different types of treatment. Besides meditation, what are some other tools that you use? I mean, like, can you kind of give us, like, a case study or some examples? If I was to walk in your door, what would we do?

Philippe Goldin: Sure. How about exercise?

Questioner4: No.

Philippe Goldin: Exercise is a powerful mood regulator. But one of the things that happens there– because we’re actually doing a study right now. Brain imaging pre-post exercise for two and a half months for people with anxiety. That may or may not be just as effective as mindfulness meditation or even cognitive-behavioral therapy. But it might be very different mechanisms. So that’s something. A whole other thing that we’re not studying that could be very powerful to study since we are so embedded in logos or language is communication skills.

How we actually process language. Even training ourselves to use language and linguistic processing in a way that’s less harmful to self and others. That would be a whole other method that’s not about therapy. It’s not about meditation. Those are at least two examples that come to mind. And even, like, we talked about mindfulness. Here’s a whole other realm with just compassion. So, for example, here’s a thought.

You take somebody who has an eating disorder, be it bulimia or binging or whatever or anorexia. Could you actually train the person to view themselves via compassion meditation on the self and others to actually move around the distorted self-view that leads to constriction of food or dissolving into food or vomiting, et cetera? I’m not sure that’s been studied but there are approaches. So, for example, I think we have to think outside the box right now. Google is a thinking company. And that’s exactly what we need to do as well instead of just staying with our normal, you know, psychotherapies, our trainings. There may be other ways to work with the mind that could be more powerful that we just haven’t tried yet or thought about.

Just to be clear, mindfulness meditation is one type of meditation. There are many, many, many kinds of meditation, for example. Many of which haven’t even been translated or incorporated into Western psychotherapy yet. Zen has in the dialectic behavioral therapy, mindfulness-based cognitive therapy, et cetera. But there are many other techniques. Yeah. That are waiting to be tried out.

Questioner5: So it’s my experience and I also read that basically if you take any kind of action or just express the emotion then it basically becomes less. Has there been any study on that aspect or did you touch that?

Philippe Goldin: Did you say just expressing the emotion?

Questioner5: Expressing or just any other kind of action, body motion, rather than just keeping it within? Basically, obviously, it has an effect on you.

Philippe Goldin: Yeah, in general. Yes. Actually there’s a very elegant study by David Creswell. He was at UCLA and now he’s at Carnegie Mellon. Where he just had people doing emotional labeling using language in an MRI scanner and found that just the act of applying a word, or a label, or a phrase to describe the emotion that one is feeling in the moment helps to reduce Amagdyla reactivity. Helps to actually shift neural activity in the brain. That’s emotion labeling; motion expression, catharsis, in many cases can be helpful. But we also know that it has to be done in a very skillful manner. So, for example, exposure therapy has to do with exposing one’s self to what I fear and addressing it.

So, for example, exposure therapy for post-traumatic stress disorder can either be very effective if done well, repeatedly, in a very concrete fashion, but it can also totally backfire. And you can see people actually melting down emotionally when they’re trying to express and relive an emotion. So it’s more situation and context and person dependent. So no blanket thing that catharsis or emotional expression is always helpful.

The other issue here is how is it affecting the other people? Maybe it’s beneficial for me. But I also– the people around me– if I’m doing it with a professional versus a friend or at work or whatever, I have to recognize that it may have different repercussions depending on which context I’m in.

Questioner5: Thank you. This is wonderful to hear. You’ve mentioned a lot of great things. I’m really curious about the fact that neuroscience is very excited about compassion recently. And it’s wonderful when we hear that sciences are validating age-old wisdoms, so. The idea of slowing down, being more mindful, being in the present, good food, exercise, so.

Philippe Goldin: Good friends.

Questioner5: Good friends. Good relationships. All of that good loving, yeah. I’m just curious whether or not you have a certain perspective on how that fits into our society, because those age-old wisdoms are sound and true. But in a society where we’re constantly fragmented, or even the idea of memory, it’s being fragmented even by the fact that we’re searching every day and we don’t bother remembering things. Memory is important from an emotional context for understanding who we are. So, yes, we’re understanding it. Yes, we’re validating it. Do you have an opinion on how we can integrate it into our lives and complementing, perhaps, our need to be fast-paced and hungry and diverse?

Philippe Goldin: That’s a great question. Introducing silence and stillness. Appreciation for silence and stillness. Going into stillness in one’s self. In little kids. In families. In fact, my favorite studies are about training whole families to become quiet. To actually take stillness as a family exercise. Can you imagine taking stillness as a work exercise? So, for example, our lab meetings. My little group, we begin in silence. The Quakers do it. Introducing silence both mentally and communally. As a practice, that’s not bizarre or weird. That actually reinforces how people feel about each other. But the key thing you’re saying is right. How do we integrate this both intrapersonally– like, in me? And that’s something that each person has to figure out. How do I find that still, quiet place inside? Nourish it. Enjoy it. Actually, like, enjoy it.

How do I experience that with other people? So in psychotherapy, this sensibility has kind of been infused lately. Mindfulness, acceptance, et cetera. And people are experimenting both in individual, couples, group therapy. In workplaces, people are recognizing that well-being is as monetarily valuable to creativity, to lack of illness, to a communal sense, and even, for example, creativity. So if the mind — if you’re a company that really requires thinking outside the box, and you know there’s different forms of stress that make me box-like — wow, gosh, I have to address that. And actively creating community, be it on a family level, be it amongst people here, be it even, like, a little work team. I don’t know what vocabulary you use. But introducing that sensibility either just as a tool for people to become more still, creative, aware. Even pausing for a moment before responding. And then again, it’s all of this– You know, there’s the muscle of attention and anyone can develop that. And then there’s becoming– search inside yourself to become more and more aware.

How does my mind work? How does my mind work? Being curious. How do I impact others? How do I understand when I feel off or emotionally off-balance? How can I bring myself back? How can I become more skillful with myself? You know, other people take care of themselves. But just myself. So I think it starts from an individual practice and then it will automatically touch other people. So just a simple example, you know?

Paul Ekman, who spoke yesterday on NPR and who’s, uh– he was a pretty intense– intense, difficult, researcher guy. He went to India specifically because his daughter wanted to meet the Dalai Lama. I don’t think Paul Ekman was interested. He went there and he was smitten. That’s the right word. Touched, smitten…by something inexplicable and so much so that he said yesterday on the radio that when he saw his wife, who did not attend this meeting, she said, “You’re not the husband I knew for the past several decades.” He’d been touched by something and he’s still trying to figure out what that is. So there’s also this sense of contagion. So emotional contagion can either drive us nuts, because somebody else is, you know, totally off-balance and is making me off-balance. That’s the negative side of contagion.

The other part can be emotional contagion or compassionate contagion where one person in the room is like, present. And other people are like, “Ooh, I feel that.” That’s a positive side of contagion. Being touched by, influenced by another person’s inner development. So that’s possible. And we have evidence that that’s possible. Yeah.

Chade-Meng Tan: Maybe one last question, if any.

Questioner6: Maybe this isn’t as related. But what’s your view on psychoanalysis and how — is that related at all or — I mean, because you were kind of — these are almost– sometimes I wonder if there are kind of bigger things that would prevent mindfulness or cognitive based therapies from actually taking as much effect?

Philippe Goldin: So Mark Epstein, New York City, psychoanalytically trained psychotherapist, also Buddhist practitioner. He has several really good books addressing exactly this question. Within psychotherapy approaches, there’s a wide range of how people work. And also it’s different skills for different kinds of problems. You would treat elevator phobia very different than relationship phobia, for example. And also, you go back to Freud. He talked about hovering — trying to get the right vocabulary. I think he said “hovering awareness”. This ability to just let the attention just rest and hover and be aware. And that actually could be — that’s one aspect of– resting in mindful awareness with nothing to do, nowhere to go, just observing, and enjoying that.

So, in fact, that could be something that arises from psychoanalytic practice. So not just theory but practice. So, yeah, I mean, we’re all humans. And we can give different vocabulary but it’s the same suffering with slightly different flavors. And it’s the same tools to restore well-being, balanced, psychological flexibility, not being stuck. And also believing that I actually can do something. That’s one of the things that arises in any form of therapy or training or even friendship – true friendship is that, “Oh, my gosh. I can expand. I can be more than this.” That is the sense.

Then you trust that and you’re hopeful that something can happen. I’m actually doing a study on hopefulness and hopelessness. And it really is — you can actually see in the brain. You can differentiate a hopeful state or a hopelessness. And even about being able to develop. Some people don’t believe we can train the brain. And that’s kind of a hopeless state. So let’s actually change that with evidence. Personal evidence.

Chade-Meng Tan: And with that, thank you, Philippe.

Philippe Goldin: Okay, thank you.

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