Does cognitively-based compassion training (CBCT) beat depression?


Authors: Mascaro, J. S., Kelley, S., Darcher, A., Negi, L. T., Worthman, C., Miller, A., & Raison.

Year: 2018

Title: Meditation buffers medical student compassion from the deleterious effects of depression

Summary: It’s no surprise to hear that the pressure from exams, and academic life in general, puts students under pressure, subjecting them to the effects of stress. This is a particular problem for medical students, given that compassion and attention to patient wellbeing are central to their professional development. Not only that, but in professional practice clinical staff may be frequently subject to the suffering of others. In an effort to study these and other issues, an experiment was undertaken to see if a course of Cognitively-Based Compassion Training (CBCT) could be integrated into the curriculum of medical students in their second year of study. A second objective was to explore the effects of CBCT on the day to day functioning of the students, specifically looking at the ability of the intervention to raise compassion scores while lowering depression levels.

In a randomized, single-blind, wait-list controlled study, the students that were provided with CBCT saw an increase in compassion and a decrease in depression compared to control. Those students that had the highest self reported levels of depression at the start of the experiment saw the most benefit from the intervention in terms of reduction to depression scores.


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Can mindfulness help you to stop smoking?

woman wearing of black sports cap

Photo by Isabella Mendes on

Authors: Maglione MA, Maher AR, Ewing B, Colaiaco B, Newberry S, Kandrack R, Shanman RM, Sorbero ME, Hempel S.

Year: 2017

Title: Efficacy of mindfulness meditation for smoking cessation: A systematic review and meta-analysis

Summary: Although there is an enduring  presumption that meditation can help people with addiction, few papers have demonstrated significant effects during randomised controlled trials. This study searched five databases in order to produce a meta study of relevant research. Ten randomised controlled trials investigating the effect of mindfulness for tobacco smoking cessation were identified. The studies had a total of 1192 participants with individual sample sizes from 27 to 412. The studies had a balance of genders (4) or more males than females (6). The average age of participants in the studies were between from 21.5 to 45.9 years and all the research was carried out in the United States of America. The meditation interventions varied from durations of 1 day to eight weeks. Five studies used only mindfulness as the intervention (monotherapy), three used a combination of mindfulness and nicotine replacement, two studies allowed the participants to augment mindfulness therapy with nicotine replacement if desired.

The meta review found only one study could be rated as good, four were described as fair and the remaining five adjudged to be poor. The point was made that eight of the studies did not disclose if the experimental assessors were ‘blinded’ to participant intervention. Four studies failed to report cessation outcomes and only one reported an  a priori power calculation. The headline finding was that mindfulness did not offer significant increases on smoking cessation compared to other interventions. The study highlighted a number of methodological weaknesses in the reported research but acknowledged the preliminary nature of understanding in this area.


Posted in addiction, mindfulness, smoking | Tagged , | 4 Comments

Intelligence linked to brain size

Meditation changes brain size?

Meditation can change brain size, but not only in one direction

Not a surprising headline until you consider that Dr Erhan Genç and Christoph Fraenz at Ruhr-Universität Bochum are reported as suggesting that people with higher scores on an intelligence test were found to have smaller brain structures.

Brains are extremely complex organs and many aspects of their function and structure are not yet fully understood. However we do know that neurons usually gather data from adjacent (presynaptic) neurons through complex tree-like structures containing many dendrites. The dendrites communicate with their own neuron’s cell body. Based on the messages received through the dendrites, a cell may fire (create an action potential) or not. When an action potential is generated, a message is then sent out to other neurons (postsynaptic) through the axon terminal. The reports of this study (I haven’t read the actual paper yet) is suggestive that people with fewer dendrites feeding into certain neurons in the cerebral cortex had higher IQ scores.

Dendrite (PSF)There are typically large numbers of dendrites communicating with each neuron in the cerebral cortex. There is a putative logic which could argue that smaller dendrite trees could be more efficient. Leading to a greater number of relevant action potentials being created more quickly. Given our limitations in understanding the mechanisms that lead to the generation and maintenance of dendrites, some caution needs to be expressed here. Without an appreciation of what the extra dendrites (in the participants with lower IQ scores) do, and why they are there, the picture is incomplete. Intelligence tests in general and IQ tests in particular are regarded by many experts as being reductive. It is possible that  people with a history of IQ testing could have developed dendritic structures able to support this activity. But has anything been lost in the process? Are the extra dendrites in the lower IQ scored participants simply inefficient, and of no real benefit?

So what has this got to do with meditation? I wrote recently about structural changes in the brains of meditators. A conclusion from my own investigations was that increases and decreases in brain structures are likely to be the result of intense and sustained meditation practice. So the demonstration that neurological structures become bigger or smaller is probably an unhelpful oversimplification. The relationship between the alteration in structural size in different (interrelated) regions of the brain needs to be understood and then correlated to cognitive functionality if understanding of the significance of changes is to be approached.

Rather than increasing or decreasing brain structures, meditators should probably think about their practice in terms of its deliverable goals in relation to behaviour. Brain imaging technology is still in its infancy and there are many significant problems still to overcome. We are probably decades away for being certain of the impact of complex human behaviours (like meditation) on brain structure, but we have for centuries been able to relate certain practices with behavioral changes. There are two obvious exceptions to these generalizations, age related structural decline and changes due to neurodegeneration.

It should reiterate that I haven’t seen the full report of the Genç and Fraenz paper but a report is available at Eureka Alert.

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Meditation can change the size of your brain


Authors: Kieran C.R. Fox, Savannah Nijeboer, Matthew L. Dixon, James L. Floman,
Melissa Ellamil, Samuel P. Rumak, Peter Sedlmeier, Kalina Christoff

Year: 2014

Title: Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners

Summary: As almost every contemplative scientist will point out, our understanding of what meditation can do for us in its infancy. However this investigation sets out the progress made in understanding meditation related structural changes in the brain. The researcher identified 21 studies that imaged the brains of meditators, looking for structural changes. Although most of the research was cross sectional in nature some ‘before and after’ examples are included.

This project reviewed research that used any of the six leading measures of  structural changes in the brain (volumetry, concentration, thickness, fractional anisotropy (FA), diffusivity (axial and radial) and gyrification). The selected papers were qualitative reviewed and also subject to an anatomical likelihood estimation (ALE) meta-analysis. Qualitative results highlighted nine brain areas that might have undergone structural alteration as a result of meditation practice. Seven areas of grey matter: anterior/mid-cingulate cortex, fusiform gyrus, hippocampus, inferior temporal gyrus, insular cortex, rostrolateral prefrontal cortex, somatomotor cortices and two white matter pathways: corpus callosum, superior longitudinal fasciculus.

Although Lazer et al. made efforts to link the results of morphometric neuroimaging to a range of functional studies there are a number of problems in this approach. There is little structure in how meditators and meditation methods are grouped together,  both in creating the meta analysis and explanations for alterations in  brain structures. This in part reflects the limitations of the 21 neuroimaging studies used, it is also linked to the widely documented problems in the theoretical frameworks used by contemplative science. For example common features are looked for in diverse experiments using different forms of meditation, both secular and spiritual. Although the participants from the experimental groups cited in the studies had all  meditated, they often differ significantly in the methods they use, frequency and duration of practice and time spent in intensive meditation retreat.

Despite the limitations, which are in large part symptomatic of meditation research in general, this remains an influential study fo0r both cognitive psychology and neuroscience.


Posted in cognitive psychology, neuroimaging, neuroscience, plasticity, vipassana | Tagged , , , , , , , , , , | 1 Comment

Spiritual based meditation may help preserve cognitive function


Authors: Anthony P. Zanesco, Brandon G. King, Katherine A. MacLean, Clifford D. Saron

Year: 2018

Title: Cognitive Ageing and Long-Term Maintenance of Attentional Improvements Following Meditation Training

Summary: Can meditation lead to improvements in cognitive abilities such as attention? Meditation research generally suffers from a shortage of longitudinal studies, therefore this seven year project should be applauded. Building on their earlier work which examined the effects of a three month meditation retreat on cognition. This investigation assessed the benefits of sustained practice in the following years. The findings appeared to demonstrate that age related decline in reaction time was negatively correlated with the continuation of meditation practice (regular practice leading to slower decline), following the intensive three month retreat. The research broadly concludes that the cognitive benefits achieved through periods of intensive activity, may receive protection against age related decline from regular meditation practice.

In the original retreat at least two forms of meditation were undertaken, a basic mind training and a compassion/empathy based practice, both embedded in a spiritual tradition. Inevitably it is problematic to evaluate the benefits of each of the practices or their interaction effect. As an experienced meditator I should underline that by their very nature, participants willing and able to undertake retreats of three months and sustain meditation practice over several years are probably unrepresentative of meditators generally, let alone the wider population. Limitations of ecological validity are discussed in the study. There was also insufficient information provided regarding the meditation history of participants, their levels of accomplishment, the degree of their theoretical training and information regarding secondary or special practices undertaken since the retreat.


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Deepening crisis in meditation research



Two leading researchers from contemplative science respond to a critical study of meditation and mindfulness research. In declining to address the important theoretical issues known to exist in contemplative science has an opportunity been missed?

Authors: Richard J. Davidson and Cortland J. Dahl

Year: 2018

Title: Outstanding Challenges in Scientific Research on Mindfulness and Meditation

Summary: The article begins by applauding the critique of Van Dam et al. This is only to be expected, published meditation and mindfulness research often falls short of the standards normally required of journal articles in cognitive psychology and neuroscience. The authors address the five points raised by the original article in a very linear fashion, failing to grasp the underlying issues. The same issues that have dogged meditation research since the launch of MBSR. However summerising the five rebuttals contained in the paper:

1 – The criticisms of meditation research reflect weakness in psychological research more generally.

2 – Contemplative practices are varied and scientific enquiry is only able to understand a few limited forms.

3 – Mindfulness and contemplative practices were not originally therapeutic in nature

4 – Research has failed to understand meditation in a relevant context.

5 – Mobile technology may be able to resolve some of the methodological issues.


Critique: It is important to note that Davidson and Dahl are leaders in this field but if they permit, I offer some observation as an experienced meditator and trained psychologist.

Psychology does not appear to understand meditation, the misappropriation of the term mindfulness has led contemporary meditation research into a dead end. The study of MBSR and related families of mindfulness are legitimate objects of clinical enquiry and experimental investigation. They have however little connection with mindfulness in its many forms as practiced in spiritual traditions. Buddhism is not one unified tradition, there are different approaches to what one might call mindfulness, these extend from ‘bare attention’ through to ‘shine’ as practiced in Tibetan traditions. Typically shine is engaged with after many years of stable foundational practice. The reliability of the terms ‘mindfulness’ in relation to MBSR needs some further work. The conceptual fusion of authentic spiritual practice and contemporary cognitive mindfulness is demonstrably confusing.

In a traditional context a meditation master may undertake decades of practice and years of study to understand meditation on theoretical and experiential levels. This degree of knowledge and precision is largely absent from meditation research, despite the fact that there are many accomplished meditators among the contemplative science research community. The tensions between duality and non duality exist in almost all contemplative practice, yet these understandings are almost completely absent from scientific research into mindfulness and meditation.

Contemporary mindfulness is neither an authentic meditation practice (in the traditional sense) nor a fully validated CBT. It has somehow fallen between the cracks. The problem is how can it now be successfully repositioned?

Posted in Buddhism, CBCT, clinical psychology, cognitive psychology, MBSR, mindfulness | Tagged , | 1 Comment

Compassion and palliative care


Authors: Claudia Orellana-Rios, Lukas Radbruch, Martina Kern, Yesche Regel, Andreas Anton, Shane Sinclair and Stefan Schmidt

Year: 2017

Title: Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program

Summary: Notwithstanding the extensive body of work exploring meditation and mindfulness, there is a shortage of studies that address the potential of compassion based interventions in the workplace. A national survey of palliative care practitioners had established that for 42% of respondents, frequent patient deaths was a challenging aspect of their work. Although many people report beneficial effects from delivering compassionate care, extensive exposure to suffering can be a problem for workers. This investigation recruited participants from a palliative care center in Bonn, Germany.  Ten weeks of training in meditation combining a number of elements including, mindfulness, loving kindness and tong-len was provided. A range of mixed measures were used to establish the benefits of the practice including, a battery of self reporting questionnaires, semi structured interviews and a physiological measure. In conclusion no evidence that participants experienced an increase in compassion was observed. However improvements were reported by participants in areas including self-care and emotional regulation. The was no significant change to the cortisol levels taken as part of the trial.

Given the complex nature of introducing compassion into this particular work environment, the mixed method approach should be commended. Where compassion, loving kindness and mindfulness are brought together as an ‘omnibus’ approach, a degree of epistemological plurality is likely to be required to gain a full understanding of the results. Reliably evaluating the effects of one approach (such as compassion) in such a trial, can be a challenge in itself. However to integrate three approaches (mindfulness, compassion and loving kindness) into a working environment, then to understand their effect individually and collectively, is making great demands of the self reporting instruments.

It should be noted that in a recent meta study investigating the pro-social effects of meditation, the teaching of the meditation practice by a co-author of the research was seen to be an influential factor. The precise nature of the meditation taught in this case is unclear and may, to some extent, be related to the individual approach of the teacher. The assumption that different kinds of meditation, such as compassion (tong-len), all fit within an easily replicated framework is perhaps the result of the theoretical uncertainty withing psychology towards contemplative science. There is still a shortage of data exploring how interrelated constructs such as loving kindness and compassion might influence behavior in the workplace. In this regard the study provides useful information that may help the understanding of these constructs in particular working environments.


Posted in Buddhism, compassion, health psychology, LKM, loneliness, mindfulness | Tagged , , | 1 Comment

Methodological problems in mindfulness research


Authors: Ute Kreplin, Miguel Farias & Inti A. Brazil

Year: 2017 (print), 2018 (online)

Title: The limited prosocial effects of meditation: A systematic review and meta-analysis

Summary: This systematic meta review explored the effects of meditation and mindfulness on five types of pro-social behavior (compassion, empathy, aggression, connectedness and prejudice). The study contended that although compassion and empathy were mediated by meditation, the other three factors were not. Further, that compassion levels were found only to increase when a co-author of the study was the meditation teacher or when the control group was a passive (not active) waiting list. The study highlighted a number of key problems in the ongoing study of meditation, particularly the methodological rigor often used.

However weaknesses in the scientific investigation of meditation tend to be linked to the absence of robust theoretical frameworks. For example inconsistent definitions of mindfulness and meditation. Meta studies in this field can reflect wider patterns but risk drawing together forms of meditation that may in effect, be quite different. The authors are correct to highlight the ‘theoretical mist’ surrounding meditation research and the failure of science to treat meditation as either a secular or spiritual practice. But despite citing architects and theorists of contemporary meditation, the authors fall short of explaining how the pseudo spirituality of contemporary secular meditation arose or is being sustained.


Posted in CM, cognitive psychology, compassion, critical psychology, mindfulness | Tagged | 2 Comments

Compassion, meditation and depression


Authors: Jennifer S. Mascaro,  Sean Kelley, Alana Darcher, Lobsang Tenzin Negi, Carol Worthman, Andrew Miller, Charles Raison

Year: 2018

Title: Meditation buffers medical student compassion from the deleterious effects of depression

Summary: The body of evidence demonstrating that compassion training offers significant benefit to its practitioners (and the wider community) is growing.  This particular study investigated cognitive based compassion training’s (CBCT) relationship  to the wellbeing of medical students in their second year of training. Compassion is a particularly important issue to people working in clinical settings. Because of the nature of their activity, a degree of compassion is desirable if not essential. However there is concern over issues connected to ‘compassion fatigue and ‘burn out’. A total of 59 students engaged in the research, those participants that received CBCT reported increased compassion, and decreased loneliness and depression.

Perspective: Contemplative science, health psychology


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Measuring loving kindness-compassion

Title: The development and validation of the Lovingkindness-Compassion Scale (LCS)

Author: Hyunju Cho, Seunghye Noh, Sunghyun Park, Seokjin Ryu, Ven Misan and Jong-Sun Lee

Year: 2017 (online), 2018 (print)

Summary: The thorny issue of effective trait and state scales for both loving kindness and compassion is far from resolved in psychology. In fact if anything it is less clear now than it was a decade ago. One of the problems can be attributed to attempts to merge or unify concepts with subtle differences and specific cultural weighing factors. This paper explains some of the express differences between compassion and loving kindness from a classical perspective. And justification for drawing them together is found in the ‘boundless state of mind’. However it is reasonable to ask in what way can the unlimited nature of mind be evaluated using limited psychometric measures? To what extent the LCS can align two distinct concepts in one scale will emerge over time.

The three reported highlights of the paper were

  • The LCS reflects the Buddhist concept of lovingkindness-compassion.
  • The LCS consists of three-factor with fifteen items.
  • The reliability and validity of LCS were adequate within our study.

This study was based on the definitions of compassion within a branch(es) of the Theravada tradition. So it should be stated at the outset the precise meanings established as a starting point may not reflect the whole family of Buddhism. This is not to say that other Buddhist schools (Zen, Mahayana or Vajrayana) might not wholly or partially share the definitions used. Simply that the definitions may not be representative of the wider Buddhist community. It should also be noted that the measures therefore may not reflect the explicit, not dual and absolute compassionate approaches found elsewhere in the Buddha Dharma.

Nevertheless this paper established fifteen items within three factors through the use of exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The results suggest that LCS was significantly correlated with self-compassion, compassionate love, social connectedness, empathy and satisfaction with life. This study used 469 university students as participants and the data supports the reliability and validity of the LCS to measure lovingkindness-compassion.

An extremely useful investigation into compassion and loving kindness, raises several important questions.


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