Photo credit: Darragh O'Conner on Flicker

A while back, I was having breakfast in the backyard, reading the “newspaper” (no paper, very little real news—I was reading on my laptop), and listening to music on KDFC, my favorite classical music station. They were playing some sweet piano music (a nocturne by Chopin). It was so enchantingly beautiful I closed my eyes, savoring it. Then something strange happened.

It can’t be fully described in words, except to say that I felt “one with the music.” All of my attention was focused on it, on every note, every nuance in the almost imperceptible changes in tempo and loudness.

I had known and loved this piece for many years, but it was that morning, at that very moment that I discovered the tonality of it—the way Chopin arranged the composition around a central note.

What was going on in my brain? Unintentionally, I was practicing mindfulness.

To some, the very word evokes a smirking dismissal of “new age” psychobabble. I know because I have done it myself. But that sublime encounter with Chopin prompted me to delve into the notion of mindfulness a bit more seriously.

What is mindfulness?

Simply put, being mindful means being acutely aware of what is happening now—rather than drifting into the past or musing about the future—without emotionally reacting to these ongoing events. It is the opposite of a wandering mind.

When I listened to that piece of music, I enjoyed it more than I ever had before. I was acutely aware of every note. But at the same time, I discovered the tonality, or the mechanics, of creating the music. This gave me the intellectual satisfaction of discovery but none of the emotional uplift of the music, itself.

Of course, this episode hardly matters in the grand scheme of things. If this is all there is, enjoying music on a deeper level than it’s really not worth taking the time to read this post. But my Chopin moment is only a metaphor for a much bigger phenomenon. So read on.


What’s the difference between fear and anxiety? Fear is generally elicited by particular cues or contexts. My dog becomes fearful at the sound of thunder. In the context of the African savannah, the image of a leopard is fear-provoking, but in the zoo or on TV, it is just a handsome, powerful cat.

Anxiety, on the other hand, can occur in the absence triggers. In its chronic form, it can be quite debilitating. How debilitating? PTSD is an extreme example.

Stressful experiences can precipitate acute episodes of PTSD in vulnerable people. The momentary stress we all experience when we hear a car backfire close by can trigger an anxiety attack of devastating proportions in a veteran of the Iraq war.

The natural reaction to attacks of anxiety is to try and avoid them. This can take the form of alcohol and drugs, or cognitively “taking your mind off it.” Both responses are ineffective and tend to accomplish exactly the opposite—that is increasing, instead of decreasing the anxiety.

How does mindfulness work in anxiety and PTSD?

Mindfulness employs a Jiu-Jitsu approach. Rather than trying to avoid or numb the unpleasant feelings, being mindful means acknowledging the cues that precipitate the response while remaining completely detached. Pay attention to the cues and your reaction to them; become aware of the “mechanics” of your physical and emotional response; observe how these triggers provoke your attacks as if you are watching it in a movie. When you observe and analyze something “clinically”, you rob it of its emotional punch.

Does it work?

Melissa A. Polusny, Ph.D, of the Minneapolis Veterans Affairs Health Care System, and her colleagues randomly assigned 116 veterans with PTSD to receive nine sessions of mindfulness-based stress reduction therapy (MBSR) (n = 58) or present-centered group therapy (n = 58), an active-control condition consisting of nine weekly group sessions focused on current life problems. Outcomes were assessed before, during, and after treatment and at 2-month follow-up.

Participants in the MBSR group demonstrated greater improvement in self-reported PTSD symptom severity during treatment and at 2-month follow-up. Although participants in the MBSR group were more likely to show clinically significant improvement in self-reported PTSD symptom severity (49% vs 28% with present-centered group therapy) at 2-month follow-up, there was no difference in rates of loss of PTSD diagnosis at post-treatment (42% vs 44%) or at 2-month follow-up (53% vs 47%).

The results are certainly modest. The main problem is the relatively short duration of the improvement. So it remains to be seen if more prolonged practice of MBSR would result in a commensurate prolonged effect. But the study does demonstrate that stress reduction through the practice of mindfulness definitely works.

How mindfulness changes your brain?

A lot of research on the neurobiology of meditation and its offshoot, mindfulness, has been done. Unfortunately, the vast majority of it is of poor quality. Despite that, the anatomy of brain regions that participate in mindful meditation is coming into light through the use of fMRI.

“Gray739-emphasizing-hippocampus” by Henry Vandyke Carter, Anatomy of the Human Body | Licensed under Public Domain | via Wikimedia Commons

Britta Holzel and her co-investigators, in a study published in the journal Psychiatry Research: Neuroimaging, measured the gray matter density of the hippocampus. This is an area of the brain that is known to store and regulate memories and also plays a role in the regulation of emotions.

The researchers found significant increases in density the left hippocampus. This study confirmed that structural changes in this region are detectable within 8 weeks following the participation in mindfulness training program. Other areas of interest in the brain that served as controls hand no such changes in gray matter density.


Other areas of the brain that are changed

The investigators then went a step further. Rather than stop with the pre-selected “areas of interest”, they looked at the whole brain. And, that was quite illuminating.

Exploratory analysis of the entire brain revealed four clusters with significantly greater gray matter concentration at the post-training compared with the pre-training time-point in the MBSR group. One cluster was located in the posterior cingulate cortex where an area called the insula is located.

The insula is known to be impacted in interoceptive/visceral (basically, what’s going on in your body) awareness as well as in empathic responses (your ability to know what’s going on physically and emotionally in the other person). More generally, it plays an important role in human awareness or consciousness.

One cluster was located in the left temporoparietal junction (TPJ). It has been suggested that the TPJ is a crucial structure for the conscious experience of the self, mediating spatial unity of self and body. Impaired processing at the TPJ may lead to the pathological experience of the self, such as disembodiment or out-of-body experiences. Furthermore, the TPJ is also involved in social cognition (a.k.a. social intelligence), i.e., the ability to infer states such as desires, intentions, and goals of other people.

Two clusters were identified in the cerebellum and brain stem. Now, these areas are associated with the more primitive functions of the brain, like maintenance of fine movement and balance. So what does it have to do with emotional well-being? It has been suggested that in the same way that the cerebellum regulates the rate, force, rhythm, and accuracy of movements, it also regulates the speed, capacity, consistency, and appropriateness of cognitive and emotional processes (i.e., it modulates behavior automatically around a homeostatic baseline).

Given the importance that the regulation of emotions and cognition play in healthy psychological functioning, the morphological changes in these regions might contribute to the positive effects of mindfulness meditation on the salutary changes in well-being.

In conclusion

It is becoming obvious now that mindfulness is not mere psychobabble or gobbledygook. It has a solid neuronal basis and there is increasing evidence of its salutary effect on emotional health and behavior.

So go ahead, and practice some mindful meditation. Ten minutes a day will do you good.

Dov Michaeli, MD, PhD
Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.


  1. Mindfulness meditation does work. I’ve been practicing this discipline for years to combat my ADD. My experience is that I spend much less time regretting the past and worrying about the future. Through this practice I have learned to emotionally disconnect from my thoughts and look at them as I would a TV screen. This makes it easier to change the channel.
    Why is this important. Experts in mindfulness tell us the average human mind talks to itself at a rate of 500 words per minute. 80% of these thoughts are repetitive and useless. Many are harmful. As the Buddha said,”The mind is everything. What you think, you become.”


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