Sunday, March 20, 2022

Mindfulness And Cure For Depression ,Pages from Sharon Begley's Book Train Your Mind Change You Brain

 Quieting the OCD Circuit ,

As discussed in the two preceding chapters, scientists were piling up examples of how sensory input—signals carried into the brain from the outside world— can alter the structure of the adult human brain. Thanks to neuroplasticity, the fingering digits to expand, and the extra sensory input a stroke patient experiences in constraint-induced movement therapy causes the brain’s representation of the injured arm and hand to move to healthy tissue. Thanks to neuroplasticity, depriving the visual cortex of visual signals causes it to seek other employment opportunities, such as handling sounds or touch or even language. All of these changes arose from the world outside the brain. Neuropsychiatrist Jeffrey Schwartz of the University of California–Los Angeles suspected that signals capable of changing the brain could arrive not only from the outside world through the senses. They could come from the mind itself. Schwartz and colleague Lewis Baxter had launched a behavior-therapy group to study and treat obsessive-compulsive disorder. In this neuropsychiatric disease, patients are barraged by upsetting, intrusive, unwanted thoughts (obsessions) that trigger intense urges to perform ritualistic behaviors (compulsions). Depending on the patient, the compulsion can be to wash hands, to check door locks or stove burners, to count stop signs or windows or blackbirds or anything else on which he or she has fixated. Together, the obsessions and compulsions can become all-consuming, making leaving the house, holding a job, or forming meaningful relationships just about impossible. Oddly, however, in all but the most severe cases, the intrusive thoughts and fixations feel as if they are arising from a part of the mind that is not the real you. Sufferers describe feeling as if a hijacker has taken over their brain’s controls. As a result, OCD patients who feel compelled to wash their hands know full well that their hands are not dirty; those who feel compelled to dash home to check that the front door is locked know that it is securely bolted. OCD has a lifetime prevalence of 2 to 3 percent. In round numbers, it affects an estimated 1 person in 40, or more than 67 million Americans, typically striking in adolescence or early adulthood and showing no marked preference for males or females. According to brain-imaging studies, OCD is characterized by hyperactivity in two regions: the orbital frontal cortex and the striatum. The main job of the orbital frontal cortex, which is tucked into the underside of the front of the brain, seems to be to notice when something is amiss. It is the brain’s error detector, its neurological spell-checker. When overactive, as in OCD patients, it fires repeatedly, bombarding the rest of the brain with the crushing feeling that something is wrong. The second overactive structure, the striatum, is nestled deep in the core of the brain just forward of the ears. It receives inputs from other regions, including the orbital frontal cortex and the amygdalae, twin structures that are the seat of fear and dread. Together, the circuit linking the orbital frontal cortex and striatum has been dubbed “the worry circuit” or “the OCD circuit.” Until the mid-1960s, psychiatrists thought of OCD as “treatment intractable.” They tried all sorts of therapies, from electroshock and brain surgery to drugs and lie-on-the-couch talk therapy. In the late 1960s and early 1970s, however, psychiatrists noticed that when OCD patients who were also suffering from depression took the tricyclic antidepressant clomipramine, some experienced relief from one or more of their OCD symptoms. Newer antidepressants, including Prozac, Paxil, and Zoloft, also help some patients: about 60 percent respond at least a little, and among these responders, there is a 30 to 40 percent reduction in symptoms, measured by how often the patient feels an urge to carry out a compulsion. But with some 40 percent of patients not helped at all, and with those who are helped left with 60 percent of their symptoms, there is clearly room for improvement. At about the same time that researchers found that antidepressants helped some OCD patients, a British psychologist working in a London psychiatric ward began to develop what would become the first effective behavioral therapy for the disease. In what he called “exposure and response prevention,” or ERP, Victor Meyer had patients face their fears. He first exposed them to the “trigger” of their obsessive thoughts. For instance, he would have a patient who was convinced the world is covered with germs touch all the doorknobs in a public building but would not let her wash her hands afterward (the “prevention” part of ERP can be anything from gentle coercion to physical restraint). Although Meyer reported improvement in his patients, a number of them—estimates run from 10 percent to 30 percent—are so distressed by the treatment they never complete it and never improve. By the late 1980s, UCLA’s Schwartz had another objection to ERP: its cruelty. “I just couldn’t see myself hauling patients to a public restroom, forcing them to wipe their hands all over the toilet seats, and then preventing them from washing,” he recalls. As he cast about for alternatives that were both more humane and more effective, Schwartz, a practicing Buddhist, became intrigued

with the therapeutic potential of mindfulness meditation. Mindfulness, or

mindful awareness, is the practice of observing one’s inner experiences in a way

that is fully aware but nonjudgmental. You stand outside your own mind,

observing the spontaneous thoughts and feelings that the brain throws up,

observing all this as if it were happening to someone else. In The Heart of

Buddhist Meditation, the German-born Buddhist monk Nyanaponika Thera

described it as “the clear and single-minded awareness of what actually happens

to us and in us, at the successive moments of perception. It … attends just to the

bare facts of a perception as presented either through the five physical senses or

through the mind … without reacting to them by deed, speech or by mental

comment which may be one of self-reference (like, dislike, etc.), judgment or


Schwartz decided to see if mindfulness could help his OCD patients. He had

two goals for them: to experience an OCD symptom without reacting

emotionally and to realize that the feeling that something is amiss is just the

manifestation of a wiring defect in the brain—overactivity in the OCD circuit.

Mindfulness practice, he thought, might make OCD patients aware of the true

nature of their obsessions and therefore better able to focus their attention away

from them. “It seemed worth investigating whether learning to observe your

sensations and thoughts with the calm clarity of an external witness could

strengthen the capacity to resist the insistent thoughts of OCD,” says Schwartz.

“I felt that if I could get patients to experience the OCD symptom without

reacting emotionally to the discomfort it caused, realizing instead that even the

most visceral OCD urge is actually no more than the manifestation of a brain

wiring defect that has no reality in itself, it might be tremendously therapeutic.”

If so, then mindfulness-based cognitive therapy, in which patients learn to think

about their thoughts differently, might succeed where drugs, plain-vanilla

cognitive therapy, and exposure and response prevention had failed.

The mental note-taking central to mindfulness would go something like this.

When an obsessive thought popped up, the patient would think, “My brain is

generating another obsessive thought. Don’t I know it is not real but just some

garbage thrown up by a faulty circuit?” He would think, that’s not really an urge

to wash; that’s a brain-wiring problem.

In 1987, Schwartz launched a group-therapy session in conjunction with an

ongoing study of OCD’s underlying brain abnormalities. Patients came in for

therapy, and scientists tracked their progress using the brain-imaging technique

positron-emission tomography (PET). Schwartz began showing patients their

PET scans, to emphasize that their symptoms arose from a faulty neurological circuit. One patient got it right away: “It’s not me, it’s my OCD!” she exclaimed one day. Soon other patients, too, saw that their obsessions and compulsions were not really “them” but were instead the electronic detritus of brain circuitry. Schwartz wondered, could getting patients to respond in a new way to the obsessive thoughts characteristic of their OCD actually change their brains? He therefore taught patients to use mindfulness to sharpen awareness of the fact that they do not truly believe that they left the stove on or that their hands need washing. Instead, he said, tell yourself you are just experiencing the arrival of an obsessive thought. Start saying to yourself, this thing that feels like an urge to check is in reality just a brain-wiring problem.That hunch was based on the fact that cognitive therapy is, in essence, a form

of mental training. It teaches patients a different way of approaching their

thoughts. In the case of depression, those thoughts are, all too often, sad, glum,

bleak, or otherwise “dysphoric.” Everyone gets those thoughts now and then, of

course. What’s different in patients with depression is that the thought tips them

over the emotional edge into an abyss of negative, hopeless thinking powerful

and sustained enough to trigger a full-blown episode of (typically) months-long

depression. A setback at work or a romantic rejection escalates to “Nothing will

ever go right for me; life is hopeless, and I will always be a complete loser.” As

described above, cognitive therapy teaches patients to think about these

triggering thoughts and feelings so they do not bring on a cascade of depression-triggering thoughts and major depression itself but instead become “short-lived and self-limiting,” as John Teasdale of the University of Cambridge, England, suggested.

So he made people sad. By then head of the Cognitive behavior Therapy clinic at the Center for Addiction and Mental Health in Toronto, he recruited thirty-four people who had been successfully treated for depression within the previous twenty-four months. To induce sadness, he had two surefire methods: asking the volunteers to think about a time when they felt sad and having them listen to Prokofiev’s Russia under the Mongolian Yoke. Played at half-speed, Segal says, it induces five to ten minutes of deep sadness as reliably as Beth’s death scene in Little Women. Once the volunteers were feeling blue, Segal asked them to indicate how much they agreed or disagreed with statements such as “If I fail at my work, then I am a failure as a person,” “If someone disagrees with me, it probably indicates he does not like me,” “If I don’t set the highest standards for myself, I am likely to end up as a second-rate person”—all known to reveal whether someone holds attitudes that make him vulnerable to depressive relapse. Segal found that when people had been made melancholic by remembering a sad episode in their lives or listening to the brooding Slavic melody, they were much more likely to hold these attitudes. “The experience of depression can establish strong links in the mind between sad moods and ideas of hopelessness and inadequacy,” he says. “Through repeated use, this becomes the default option for the mind: it’s like mental kindling. Even among recovered depressed patients, the degree to which sad moods ‘switch on’ these attitudes is a significant predictor of whether the patient will relapse eighteen months later.” In some people, sad thoughts unleash beliefs that put them at risk for depression..

What these patients needed, he realized, was a different way to relate to the inevitable sadness everyone experiences at one time or another, a way that would not let a passing sense of unhappiness (from schmaltzy music, no less) send them tumbling down the rabbit hole of depression. And for that, they needed to forge new neuronal connections.

Mindfulness and Depression,

 In 1992, Segal met with Cambridge’s John Teasdale and Mark Williams to turn his theory of depressive relapse—that people who hold despairing attitudes are more vulnerable to falling back into depression as a result of minor setbacks—

into a treatment. Teasdale, who had been practicing mindfulness meditation for a

number of years, had been learning about a mindfulness program developed by

Jon Kabat-Zinn of the University of Massachusetts, a longtime participant in the

Mind and Life Institute’s meetings with the Dalai Lama. Although Kabat-Zinn

used it mostly for stress reduction, Teasdale saw other possibilities: to harness

the power of the mind to treat depression. He suspected that patients might

escape repeated descents into clinical depression if they learned to regard

depressive thoughts “simply as events in the mind,” as he put it. The key would

be to help patients become aware of their thoughts and relate to them as merely

brain events rather than as absolute truths. Instead of letting a bleak experience

or thought kindle another episode of depression as predictably as a spark ignites

a fire in bone-dry kindling, instead of allowing their feeling to drag them down

into the pit of depression, patients would learn to respond with “Thoughts are not

facts” or “I can watch this thought come and go without having to respond to it.”

That, Teasdale suspected, might break the connection the brain made between

momentary unhappy thoughts and the memories, associations, and patterns of

thinking that inflate sadness into depression. It would be like putting a wall of

asbestos between the spark and the kindling. It would be, literally, rewiring the


The program the scientists developed, called mindfulness-based cognitive

therapy, consisted of eight weekly individual sessions, each lasting two hours.

Using the mindfulness training pioneered by Kabat-Zinn, the patients steered

their attention to one region of the body after another, trying to focus intently on

the sensations their hand, knee, foot was feeling at that moment. They then

learned to focus on their breathing. If their mind wandered, they were to

acknowledge it with “friendly awareness”—not frustration or anger—and focus

once again on the breath, which served as a magnet pulling them back to mindful

awareness of the moment. The patients also practiced at home, trying to notice

their thoughts impartially rather than reacting to them, and regarding their

feelings and thoughts (especially the bleak, despairing ones) as merely transient

mental events that happen to “come and go through the mind” and that are no

more significant than a butterfly floating into your field of vision. Most crucially,

they kept telling themselves that the thoughts did not reflect reality.

n 2004, Teasdale and his colleague Helen Ma replicated the findings,

showing again that mindfulness-based cognitive therapy reduced relapse. This

time, in a study of fifty-five patients, they found that for patients with three or

more episodes of major depression, the rate of relapse fell from 78 percent in the

treatment-as-usual group to 36 percent in the mindfulness-based cognitive

therapy group. “Mindfulness-based cognitive therapy,” they concluded, “is an

effective and efficient way to prevent relapse/recurrence in recovered depressed

patients with three or more previous episodes.” Or as Segal put it, “There are

modes of thinking which are more easily triggered the more they’re accessed.

Mindfulness works to keep you from triggering the depression network.” By

monitoring their own thoughts, patients who practice mindfulness are able to

keep the dysfunctional products of their mind from cascading into full-blown


You don’t have to believe in any spooky power of mind over brain to guess

what might be happening in these patients. Somehow, mental training was

altering brain circuits, in what we might call top-down plasticity, since it

originates in the brain’s cognitive processes. (“Bottom-up” plasticity is the kind

that arises when plain old sensory inputs resculpt the brain, as they do when

dyslexic children hear specially crafted sounds or lab monkeys carry out a

repetitive finger motion.) Brain-imaging technology would show precisely how mindfulness meditation was training the mind to alter brain circuitry.


  1. Thumbs up for meditation and yoga! Any kind of mindfulness practice is great though!

    1. i think meditation and yoga work like wind that direct a boat towards shore dear Debra

      i agree that mindfulness is actual solution for composing withered thoughts and focus them towards correct direction

  2. You should have been a neurologist in another life!

    1. dear Christine for my whole life i knew i have something particular but had no clue what it was ,Nature raised circumstances to make think about finding it out and here i am after long course of yoga and meditation with perspective that seems to point out what can i do to feel that "fulfilment" that i missed in my inner space ,i still don't know how but now i know what ,at least

  3. Dear Baili, It delights me to see that you are studying the brain and mindfulness. I know from following you for years that you are an old soul. Did you realize that consciousness is one element of human existence that scientists have not been able to explain. Oh, yes, they have theories, but no proof. You and I know that consciousness comes from the Universe … God. You and I know each other through our souls and we recognize one another right here in the blogosphere. I also am reading a new book about keeping the brain sharp as one gets older. The name of the book is Keep Sharp by Sanjay Gupta, MD. I highly recommend it. Thank you for sharing your studies. Please take good care of yourself and stay safe. John

    1. thank you so much for calling me an "old soul" dear John it made me smile because it reminded me days of my teenage when many used this phrase for me though i still receive such comments but i am glad i am actually old now thank goodness and believe it or not i waited to grow old because i found this age fascinating always :)

      I think letting humans know what the soul is out of Nature's plan ,Nature's actual plan seems that we the humans should find ways to think clearer and to feel deeper ,this will make them realize how soul is dwells and prevails within the scenario of universe .
      So we are asked to not just look but observe ,feel and realize ,this is totally spiritually journey and beyond physical approach .
      yes i feel so privileged that i always had connection with everything came front of my physical eyes and went under my spiritual observation .this is so special pleasure indeed .
      thank you so much for the recommendation i will surely read it if find online

  4. I believe firmly in the theory behind this work. There was a period of time when I was first living on my own after university where I started having obsessive thinking. With the help of my then-boyfriend (who became my husband), I was able to overcome it, using very similar tools. Obsessive-compulsive behavior is so, so difficult to live with. I'm glad this research is being published and I'm glad you are sharing it, baili.

    1. dear Jenny
      i think once in a while we all go under such intense and complex state of mind , you were lucky that you had partner who helped you to realize
      dear Jenny i think once in a while we all go under such intense and complex state of mind , you were lucky that you had partner who helped you to realize that how you cat get through tunnel .

      my most stern times began after we moved into our new house ,me and hubby both are "feelers" fortunately and it takes us little time to understand there is something particularly wrong so we both felt soon that we are becoming target of " applied negative energy " because we knew that we were never in such mental state even when we were under lots of pressure while living with my in laws . That was me though who first tried to analyze my own thoughts and the how they were being formed ,soon with my very first move to do so i felt that i was being hurt somehow ,my head and body would get feeling of being nailed ,weird pain ,dizziness and blur eye sight etc.

      that confirmed that one who was applying negative energy to us was observing our behaviors and thoughts closely and when i tried to break that cage of negativity he got alert and mad . That seemed so challenging and i like challenge specially when they ask to explore my mental power so i started to search about it though nothing was of much help .I realized for the first time in my life that it is only me who can save myself and nothing else so gradually i started yoga and then meditation ,i am doing both since more than ten years now and believe me it has changed me completely almost ,i am very different person with undefeatable positive attitude ,calm and focused and with little better understanding of life and everything .

      my inner world is serene and i feel that as compare to my life prior to this was lived only half and what i have discovered now is "full" face of life which is really beautiful and worth seeing by all of us equally .

      my constant meditation has enabled me to sit calmly as guard in my own head room and let enter only one i want to just as Karen said below . this self awareness is crucial to lead life with least chance of mistake for which i am grateful !

    2. I can always feel the serenity in your writing, baili. That is such an important ingredient for a contented life and I am glad you were able to find it through your meditation.

    3. it is amazing to reveal that peace we look in world around us for is actually located in the deep core of our being ,all we need to pause ,take deep breath and start journey to our inner universe which is waiting for us to open numerous new horizons for us that change our perspective about physical world around us completely ,reality that we create through our physical existence can be ugly most of the times but our inner universe has divine truth that make us to face this ugliness with hope and faith and add our own goodness to decrease it little bit

    4. i want to add apology for late response dear Jenny ,we had to go to other city to attend a wedding ceremony

  5. Depression and other mental problems are one the many side effects of this pandemia and war, baili.
    Have a great week

    1. what i feel after my so little learning about human brain dear Pedro is that human brain can be used on different levels ,we are using our brain mostly that belong to our most immediate and most spontaneous response , we do so because we are habitual to it and it is easiest thing to do.
      but if with little effort we can activate "higher" level of our brain and instead of immediate and spontaneous response learn to pause first ,process the thought carefully ,ponder upon possibilities regarding consequences we can make this world a better place with inhabitants who have much healthy approach for life . the higher is level of thinking the better is standard of life for all .
      nature can rethink about our fate if we try this way i believe because she seems to demand from us for such responsible behavior believe me

  6. The mind/ brain does a lot of work and sometimes things go wrong. A good read Baili, thanks for sharing and take care.

    1. things go wrong when there is something missing in processing them dear Margaret

      i dream of future when children will be trained in their primary classes how to train their mind and they will grow as far better people than us with least interest to even think about it

  7. O estudo do cérebro é, ao mesmo tempo, uma coisa muito interessante e muito complexa. Parabéns por ter a curiosidade e a coragem de o fazer.
    Uma boa semana com muita saúde.
    Um beijo.

    1. i confess that i tried to learn swimming when i was thrown into the ocean dear Grace ,i consider my survival a miracle indeed

  8. Thank you for sharing your studies.

    My good wishes for the week ahead.
    Take care.

    All the best Jan

  9. It's so wonderful that there are highly trained professionals and scientists to help those who are suffering from these disorders. The brain is so complex and there is still so much to learn. I used to suffer from depression until I started practicing gratitude through mindfulness. I read many books on positive thinking and learned to direct my thoughts towards things that lifted my spirits. It didn't happen right away, but I worked hard and now I am practiced at focusing my attention and thoughts towards positivity. I still have times when I feel depressed, but it only lasts a day or so. I am grateful for all the people who study these things and work to help others through treatments, studies and books. Thank you for sharing a very important subject, Baili. x K

    1. dear Karen in far past brain was something unimaginable and mysterious ,then physical science explained what it is and how functions but human curiosity is not formed to satisfy with obtained knowledge .neuroscientists could not explore human brain beyond it's chemical reactions . "Human mind" was still a puzzle waiting for solution but science has no equipment or experimental ways to capture or define what is "mind" and how it interacts with brain. Than philosophers tried to explain human mind with their thought experiments . Today we except that mind is smoothing far more powerful than human physical brain and it's influence can reshape the human brain in an incredible way .

      when i started my yoga and meditation i had no idea what it will do for me in future ,but when i kept practicing them regularly for many years i noticed how my way of thinking was changing slowly and smoothly .

      our brain is like engine in a vehicle a corrupted engine can increase the chance for accidents but if it is fresh ,calm and precise it will be joy to driver's soul .

      i can see how my changed attitude had influenced my life positively on every level thankfully

  10. Thank you for sharing this, Baili. Mindfulness is something that I practice daily. It helps me to stay focused and to ground myself.

    1. i think there is hardly another way dear Martha to obtain inner stability and peace . money can buy one all the stuff but what matters most is hidden within us by creator what an incredible justice indeed

  11. Mindfulness is something I too have had to consider more in recent weeks, Baili. In truth, I may already have been observing it but never recognized it by that name. I appreciate the information you shared in this post, even if I did get a bit "lost".

    1. i know the post got lengthy dear Dorothy but for those who have interest i wanted to share it with it's complete perspective .

      it is great that you have been practicing mindfulness .it is first step towards self realization and opens the inner horizons to practitioner

  12. Thanks for sharing this, Baili! I really need to try mindfulness and meditation. I definitely have struggled with depression throughout my life. I'm getting better at talking myself back from falling over the edge into the abyss of deep depression. I can choose not to go there a lot of the time. That said, I am not going to stop my medication. It has literally saved my life and is most effective at helping me control suicidal thoughts.

    1. that was terrible to know that an amazingly talented lady like you who had love of her life with her an extraordinary mind to speak and share and excellent way to say everything so inspiringly can go under depression any time ???

      what i can guess with my tiny simple mind is that as i know you are astonishingly talented and have gift to share it with others and while doing so comes time when you feel pressure of meeting so many deadlines or something like that ?
      though i cannot assume this can be responsible for suicidal thoughts . i think you are far wise to think better than e and have striking ability to reach and uproot this problem dearest Louise !
      i would love to keep in touch and know why you said so and is this long gone issue or you are dealing with it currently ? we can talk through emails but i will wait for you to do it first so i can understand you allowed me to speak further .

  13. Thank you, dear Baili! I don't mind speaking about my depression. I think it's important to speak out about it, so that others with depression know they can seek help and not be ashamed because they struggle with depression.

    I can trace depression in my family from my great grandfather Pratt to nieces in my sisters' families ~ that's five generations. I can't go back before that, because my great grandfather came over to Prince Edward Island, Canada, from Scotland as an orphan. He was about nine years old. A family on the boat took him in, and he took their last name of Pratt.

    We used to call what was wrong with my father and me manic depression. The modern term is bipolar disorder. Suicidal thoughts are part of this disorder. I've struggled with suicidal thoughts since I was fourteen or fifteen. My father suffered terribly and actually attempted suicide several times.

    Naddy, my niece, is one of the kids in the next generation who deals with this "family curse." She is outspoken about it. She has just finished her academic courses in veterinary school and is about to start her clinical work in her last year at school. That's when she gets to practice what she has learned while treating animals in a variety of situations under the guidance of veterinaries. She is a fierce advocate for taking care of one's medical health, especially in the medical fields.

    I finally sought treatment when Vice President Gore's wife, as Second Lady, was a champion for mental health. She shared her experiences and encouraged people strongly to get help for mental illness. So I finally did. I was prescribed drugs, and unfortunately I am one of those people who will have to take them throughout my life. I'm so grateful for the drugs, because they have helped me immensely. I wish they had been available for my father, because he wouldn't have suffered so much.

    I still get strong suicidal thoughts probably six or seven times a year, even with medication. But I have learned ways to pull myself out of them. I recognize that my thoughts are telling me things that are not true , and I try to distance myself from without judging myself for them. And I find getting up and doing something physical like scrubbing a floor, going for a walk, or making soup helps me. I have a number of techniques, and I'm still here alive and kicking.

    Thanks for being such a caring friend! Hugs and love to you!

  14. thank you for sharing all this with me dear Louise ,forget my ignorance that i never knew there is some mental disorder in which suicidal thoughts are essential .

    i felt really inspired and impressed (finding no better words that can tell you what i feel about you since i read your stories) since i came across your blog and read stories about your stay in uneasy place (sorry forgot name at the moment) where your father was appointed as teacher . i feel so related and it is because of your striking honesty and art to say things so beautifully dear Louise .
    i am sorry that your family suffered with this particular disease since generations ,i won't call it curse though i myself am victim of something like that though not regarding suicidal thoughts but yes in other matters . i feel there are thoughts rising in my head with which i cannot connect and since i started to detect and neglect them after grave meditation and yoga i can see how that disease has brought goodness in my life because if there was not such thing i would have hardly thought about trying things that strengthened my mindset and directed my mental energy towards positive stuff .

    now when you have mentioned this disorder i would like to dig it little bit and share with you where are it's roots and how can you pull them out


Protected by Copyscape DMCA Copyright Protection