how we can change the wiring of our brains€¦ · the one we’re going to focus on tonight is...

How We Can Change the Wiring of Our Brains

A Teleseminar Session with Daniel Siegel, MD

and Ruth Buczynski, PhD

The National Institute for the Clinical Application of

Behavioral Medicinenicabmwww.nicabm.com

Neurobiology of Mindfulness: Clinical Applications 2

The National Institute for the Clinical Application of Behavioral Medicinewww.nicabm.com

A complete transcript of a Teleseminar Session featuring Daniel Siegel, MD and conducted by Ruth Buczynski, PhD of NICABM

How We Can Change the Wiring of Our Brains

Contents:

How to Define Mindsight ......................................................................... 3

Why Cultivating Mindsight Can Change ................................................ 5the Brain’s Physical Structure

How Mindsight Helps Our Brains Achieve ............................................. 6and Maintain Neuronal Integration

How FACES Illuminates the Path to Integration ................................... 7

How to Stimulate Neuronal Activation and Growth ............................ 11

How Mindfulness Can Amplify Neuroplasticity ................................... 14

How the Hippocampus Can Be Utilized to ........................................... 16Heal Trauma and PTSD

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Neurobiology of Mindfulness: Clinical Applications

How We Can Change the Wiring of Our Brains with Danial Siegel, MD and Ruth Buczynski, PhD

Dr. Buczynski: Hello everyone. I want to say welcome to the call tonight. We’re glad to have you join us in our on-going series on the brain. We have people calling in from all over the United States and many parts of the world, and it’s so exciting to see how many people are calling in on this series.

I am Dr. Ruth Buczynski, a licensed psychologist in Connecticut, and President of the National Institute for the Clinical Application if Behavioral Medicine. My guest is Dr. Daniel Siegel. Dan is a physician, and is the author of some very wonderful books, and I am a fan of Dan’s books.

The one we’re going to focus on tonight is called Mindsight- The New Science of Personal Transformation. It’s just off the press, but you may also know him from The Developing Mind Toward a Neurobiology of Interpersonal Experience, and a book that he also wrote for parents called Parenting from the Inside Out - How a Deeper Self Understanding Can Help You Raise Children Who Thrive.

So, welcome Dan.

Dr. Siegel: Thank you Ruth. It’s good to be here.

Dr. Buczynski: We have a packed agenda, and I want us to dive right in and we’ll get started thinking about how cultivating mindsight can change the brain’s physical structure. But before we do that, let’s define mindsight. What actually is it?

How to Define Mindsight

Dr. Siegel: Well, mindsight is a term that I made up, basically to embody the idea that we have two “lenses” with which we see the world. One is an external lens or a kind if physical sight if you will. You can see things that you hold in your hands, or things that you might see with your eyes. It’s the physical property of matter really that we can see.

But then, there’s the lens that we have where we can see the inner world of mental experience in ourselves, which you could easily call insight, and to see it in other people, which you could call empathy. But mindsight is more than just insight and empathy; it actually allows us to not only see the inner world, but then to shape it.

So mindsight is really a skill that allows you to focus more deeply in the inner world of yourself or others, and then to help either you or other people move that inner world toward health. And that’s a whole other topic of how this mindsight view defines health, but mindsight then, is the capacity to see and shape the inner world.

Dr. Buczynski: Let’s go ahead and talk about how it defines health before we jump into how it changes the brain’s structure.

Dr. Siegel: Sure. Well, this is what happened with me, and it’s just the short version. When I was being trained as a physician, I found that the professors that taught me didn’t teach about the inner world of the



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patients. They were teaching about the physical properties, you know, liver cells, heart cells, and even neuronal cells.

But the experience I had as a student was that they were blind to the mind. And this was very confusing to me, and so my ability to learn ways, for example, of dealing with my own feelings of empathy for others and how overwhelming it must be for people to be facing a medical illness where they were dying…and the lack of being given any skills made me start working internally, kind of in a private way, on ways I could see internally and shape my world in a more positive direction.

When I ultimately went into pediatrics and transferred into psychology, I found too that the disorders that were described in the DSM included a wide array of different difficulties that we could encounter as human beings.

But to me they seem to fall into these two patterns: chaos on the one hand and rigidity on the other. Things were either stuck, rigid, or depleted, like in depression for example, or they were flooding you, and chaotic, and totally unpredictable, like in post-traumatic disorder flashbacks or mania.

So, I tried to make sense of that impression that the world sort of seemed to be filled with categories of chaos, rigidity, or both, and as I started exploring….the developing mind, what came to me during this scientific journey was the notion that health was this state of integration that had a harmonious quality. It had the boundaries as if it were a river, on one side was rigidity and on the other side, chaos.

And you could then look to the science of mathematics and derive from the probability theory part of mathematics in particular, complexity theory, a view of elements in a system that can specialize and join with each other and differentiate. Then you take the differentiated components and link them together, and that’s basically what integration is.

When this system was integrated, that is, when it linked differentiated parts, the system had these qualities of being flexible, adaptive, coherent, energized, and stable; it spells the word FACES.

And that FACES flow is exactly what you feel, for example, when a choir sings in harmony. So the definition from the mindsight perspective is that health is integration.

So if you’re looking at a human body and having energy and information flow within that body in an integrated way, that’s the definition of inner health.

If you’re looking at a relationship, let’s say between you and me, Ruth, we want to make sure that you

“Mindsight is more than just insight and empathy; it actually allows us to not only see the inner world, but then to shape it.”

“If you’re looking at a human body and having energy and information flow within that body in an integrated way, that’s the definition of inner health.”

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can be differentiated from me and I’m differentiated from you. We don’t just sit here in silence with each other, but we link through patterns of communication that are respectful and compassionate. That would be an example of an integrated relationship.

You could even look, for example, at how a school functions, or a community and apply this principle of integration. Whatever level of systems analysis you want to place, integration allows us to understand how a community, a school, a couple, a family, or an individual all achieve states of health when the system is integrated.

So, this is the model that I use from the mindsight perspective and it informs this larger field I work in called interpersonal neurobiology, which is a whole other story, but basically the foundation from which we approach a healthy system, a healthy person, or a group of people.

Dr. Buczynski: Great. Now, if there’s time, we’re going to go all over the place and look at how we could integrate that in our perspective on depression, and on trauma, and on working with couples, but first I would like to just focus on that brain and how cultivating mindsight can change the brain’s physical structure.

Why Cultivating Mindsight Can Change the Brain’s Physical Structure

Dr. Siegel: Well, you know, the exciting thing about being in the field of clinical work, whether you’re working directly in the psychotherapy field, or even in various aspects of mental health related to psychotherapy, or even in the medical world, we’re in a moment now of making one if the most revolutionary findings from science, in particular from neuroscience, which is the study of neuroplasticity.

Neuroplasticity is the way we can study how the connections in the brain, the literal physical connection with the substance of the brain’s architecture, how those connections continually change throughout the life span. Experience drives those changes by activating the firing of neurons, and then as neurons fire, they can rewire their connections to one another.

That’s the basic finding from neuroplasticity and what we’re now learning is that the brain doesn’t stop growing after childhood or adolescence; it continues to grow throughout the entire life span. So whether that’s from new synaptic connections or simulating these cells called neurostem cells to differentiate and become specialized neurons or even the growth of myelin, which is the sheath that allows the conduction speed between neurons to be increased even in the resting time after a neuron fires, and it has to rest.

But when you have myelin, you actually rest about thirty times less and your speed is about one hundred times more. So basically, you’ve not only added synaptic connection, or grown new synapses by stimulating neurons to grow from stem cells, but you’ve also added myelin, and you’ve basically

“Neuroplasticity is the way we can study how the connections in the brain, the literal physical connection with the substance of the brain’s architecture, how those connections continually change throughout life.”



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increased connectivity of a circuit by three thousand times.

So, when you’re asking the question, how mindsight changes the structure of the brain, we’ll get into exactly what it means, but you can focus attention, which is basically harnessing the power of the mind to focus energy and information flow through the substance of the brain.

And as you do that, you can change synaptic connections, you can likely stimulate the growth of new neurons, and you are likely developing a mindsight skill. Skill development, different from just memory, is based on mild ingrowths. So in all those ways, we can change the physical structure of the brain to the focus of the mind.

Dr. Buczynski: Great. Let’s talk about how mindsight helps our brains achieve this neuronal integration. Let’s go down and get more specific with it.

How Mindsight Helps Our Brains Achieve and Maintain Neuronal Integration

Dr. Siegel: Well, here’s the thing, on the simplest level, we can say that when a person is on automatic pilot…All of us have a mind of course, but not all of us have well developed mindsight skills. So having thoughts and feelings, having consciousness and unconscious processes, having images in your mind’s eye, having dreams and hopes, and attitudes and intentions and beliefs…all of that are mental activities and all of that is something you can have without having mindsight.

Mindsight is the capacity to sense that those mental activities are, in fact, not the totality of who you are. So in that sense, it overlaps with mindfulness when you have discernment, but it goes beyond mindfulness because once you have this ability to sense that these mental activities are just part of your identity, you then specifically can move the way your energy and information flow is happening in your mental life, in your relational life, or even in your neuronal life.

So if we look at these three elements, mind, relationships, and brain; and with mindsight, you then use your skill of tracking energy flow and information flow of the mind, the brain, and relationships - three aspects of one reality, and you drive that toward differentiating elements and then linking them, which is the basis of integration.

“But when you have myelin, you actually rest about thirty times less and your speed is about one hundred times more. So basically, you’ve not only added synaptic connection, or grown new synapses by stimulating neurons to grow from stem cells, but you’ve also added myelin, and you’ve basically increased connectivity of a circuit by three thousand times.”

“Mindsight is the capacity to sense that those mental activities are, in fact, not the totality of who you are.”

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What our experience is, mine and my students, is that when you develop these mindsight skills in both yourself and your clients, you can actually teach people how to take a life that’s filled with chaos and rigidity, which are signs if impaired integration, and you can specifically identify where integration is impaired. That is, an area of the brain that hasn’t been differentiated, and therefore if it’s not differentiated it can’t be linked. Sometimes there is differentiation, like in trauma, but there’s no linkage.

And then you use the focus of your attention with these mindsight skills to actually promote differentiation and linkage of these specialized parts and what results, which is unbelievably rewarding, is that people who’ve been stuck in chaos and rigidity in their lives, can find liberation from that as they move into more integrated neuronal states. Literally, it is a form of neuronal integration.

So, mindsight is a very useful clinical construct. Obviously it’s a word, but it allows us to develop what I believe is a physiological skill where you allow yourself to move from being on automatic pilot, and the brain is basically yanking you around into states of chaos or rigidity, which basically by the way, explains the entire DSM.

The Diagnostic and Statistical Manual is filled with examples of chaos and rigidity, or both and one way that we’ve used DSM is as a manual of nonintegrated states that lead to psychological distress. So here, we’re saying, if that’s the case, if you can rethink the DSM, as a manual of nonintegrated states, then our task as therapists is to decide if we can help other people get out of those various patterns of non-integration and look very specifically at energy information flow patterns, and how they’re not integrated and actually use the focus of the mind to change these nonintegrated brain states.

And what we’re finding is that from a clinical point of view, we can do that, and now what we can set up are the experimental conditions to prove, in fact, that the brain is changing.

Right now, since this is such a new intervention, we’re really at a place of saying these functional changes are likely coming from changes in the brain. And so, this so just a very exciting moment to take the brain work and move it into the more control research realm.

Dr. Buczynski: Now I’d like to have us perhaps, talk about a case. Let’s just take an example of this so that people, I think, would get a fresher perspective on it. But before we do, you refer to FACES, and that’s an acronym for integration, and can you just briefly go through the five parts of that?

How FACES Illuminates the Path to Integration

Dr. Siegel: Sure, and Ruth, I have to confess, I am an acronym addict. Here’s the idea of acronyms of course, and I think your question is a real opportunity to pause for a moment and say this, you and I are using language to communicate with each other right now and in our field of course, and just with maybe being human, we use language to try to get ideas across.

“Use the focus of your attention with these mindsight skills to actually promote differentiation and linkage into more integrated neuronal states.”



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It’s really important to be very humble about that and say that words are very limited in how they capture reality, and if we can be really circumspect about it and say, okay, there’s a word called mindsight, or let’s say FACES, these words should illuminate a path and not imprison us in a vocabulary list.

And that’s really important because even with something like mindsight, I mean, it’s a really, really helpful construct when you’re a medical student and your professors are acting like the mind doesn’t exist, so you keep yourself sane; you say, okay, this person doesn’t have mindsight. They’re a nice person, she’s very nice, but she’s very blind to something even though I can’t weigh it.

So, it kept me sane, and it happened to be extremely useful for seeing patients’ situations in a very different way by looking at integration and all that. But it’s an idea, and if the idea doesn’t work for someone listening to this, that’s fine. They shouldn’t use it.

What I’m finding with my seminar students is that the construct is very useful, but like with the term FACES that I’m about to describe, we should make these words help us, not put us in a restricted place. They’re maps of the territory, not the territory.

And a map is really good; it gets you around, but you can’t keep on looking at the map. Once you get to the beach, just enjoy the beach—that kind of thing. So, FACES is just a word, you know, when I was looking at the mathematics of integration, and by the way, mathematicians don’t use the word integration, because for them, integration is the same as addition. Whereas, in plain language, integration means that the elements of a system maintain their differentiated aspects, and they link.

But when you hang out with mathematicians, or physicists, they never use the word integration. For them, the whole is identical to the sum of the parts. When you integrate five and three, for example, eight is your integration. Eight loses any elements of five and three, and that for a mathematician is integration.

So, you won’t see the word integration, but when you sit down with physicists or mathematicians that study complex systems, which I’ve been able to do, you’ll find a complex system is prone to have a self-organizational process, where elements of the system differentiate and they link, which for us in plain language is integration. For them, this linkage of differentiated parts allows the complex system to move toward maximizing complexity, and when you analyze that, it has the features of FACES.

It’s just a word I made up, but it means flexible, adaptive, coherent, energized, and stable. FACES is a way of describing the harmonious flow of an integrated system, and when you’re not in a FACES flow, you move either toward chaos, rigidity, or both.

“Mindsight is a very useful clinical construct from a clinical point of view. We can set up all the experimental conditions to prove, in fact, that the brain is changing.”

“Integration means that the elements of a system maintain their differentiated aspects, and they link.”

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In the local seminars I have here in LA we have a lot of laughter, goofy but memorable acronyms just because these ideas are wonderfully rich and the beautiful thing about it is if a therapist can take these ideas, and just make them their own, an acronym can help them do that.

You’re not quickly running to notes or wondering what someone said. It becomes yours, and that’s the whole idea of how we empower not only ourselves as therapists, but then we empower our clients; because these ideas should just be really organic to the process of a relationship unfolding.

So, an acronym just helps you quickly go, “Wow, this person is not in the FACES flow. They’re really chaotic right now. What is the domain that’s not integrated?” It’s really a very simple model, and it’s unbelievably powerful.

Dr. Buczynski: So, can we perhaps focus on an example?

Dr. Siegel: Sure, well let me give you a choice. In the mindsight book, what I did was try to choose examples of actual people I worked with where their particular journey was an illustration of one of basically eight domains of integration.

So, integration is a broad concept, and you can apply it in very specific ways. You tell me what you’d like. I could talk about a ninety-two year old who came in with all sorts of rigidity in his life, and that had become massively increased when his wife of sixty-five years became ill. He’s a good example of what’s called bilateral integration.

There’s also a woman I treated who’s an example of vertical integration impairment.

And then there’s the basic starting place: a sixteen year old boy I’ll call “Jonathan,” who had impairment in what’s called the integration of consciousness. There we use what’s called a “wheel of awareness” process to actually integrate consciousness for him. So, you tell me. I love all these people and I love the processes so I can talk about any of them you want.

Dr. Buczynski: How about we start with the ninety-two year old gentleman.

Dr. Siegel: Sure. Well, he was a case where someone, I guess, heard me in a lecture and then told a relative, who told a friend…that kind of thing, and the son brought his dad in.

So, we’ll call the ninety-two year old gentleman “Stewart.” Stewart comes in and his son says that he thinks his dad might be depressed, and he’s heard about that sort of thing on the radio and a friend of his told him about me.

“FACES (flexible, adaptive, coherent, energized, and stable) is a way of describing the harmonious flow of an integrated system, and when you’re not in a FACES flow, you move either toward chaos, rigidity, or both.”



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Stewart was basically withdrawn and cantankerous, but the feeling I got when I sat with him wasn’t that he was sad or depressed, but that there was something just kind of vacuous and disconnected about him.

As you know, there are these systems of neurons we have in our own bodies—these mirror neurons and other aspects of what I call the resonant circuits, which allow us to resonate with the internal state of another person and sometimes those signals are not very worthwhile and sometimes they’re extremely helpful.

So, I just registered that Stewart didn’t seem depressed even though the son said that was his deal.

When I ultimately got a chance to talk to Stewart alone, he still didn’t seem depressed. He seemed more aloof than anything else, and yet his cognition at ninety-two was totally in tact—excellent memory, excellent memory for facts, and I did a very brief adult attachment assessment, which I do with most of my patients.

We came up with this sense that Stewart….even though being a lawyer …he thought it absolutely a moot point that I was reviewing his relationship with his parents, which was almost ninety years ago and he used that as evidence to say, “You know, you’re out of your mind,” but I said that synaptic connections get formed early in life.

And the kind of narrative that he was giving me now, where he didn’t remember much about his childhood experiences, but he remembered the facts of his childhood, not the actual experiences, and that showed a big difference between left and right hemisphere. The left dominates in factual memory, and the right dominates in autobiographical, and he didn’t have much of that.

He also kept insisting that relationships didn’t matter in his life, and his son included that he’s always had that attitude. His wife was able to give me the information that his parents, just as Stewart had kind of factually stated, were in her words, “The coldest people on the planet.”

They lacked mindsight and the ability to see the internal world. Everything was about managing Stewart’s behavior and the physicality of his life—his food, his shelter, his schooling, but nothing was focused on feelings or thoughts, or the meaning of things.

So, the hypothesis that I said to Stewart as we engaged in a very short course of therapy for him, was that I felt that the recent illness of his wife had made him go more into withdrawal from relationships, and what I could gather from the initial assessment was that he had this impairment of integration across his two hemispheres.

“Integration is a broad concept that you can apply in very specific ways; different types includebilateral, vertical, and the integration of conciousness.”

“Synaptic connections get formed early in life..”

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The more I did tests of right and left hemisphere functioning, (I found that) they really weren’t very well developed. For example, awareness of your bodily sense of self and the integrated map of the body is only a right hemisphere (function); that autobiographical self, as I mentioned, was not very well developed in Stewart.

So, I said, “You can go on like this if you want. I don’t think you’re depressed. I think you’re living with half a brain. And you can continue life like this. I’m not telling you what to do, and it certainly isn’t for your son or wife to tell you what to do, but I just want to offer you the idea that you did the best you could in your childhood, but the lack of focus on you internal world didn’t develop that part of your brain, so you’ve lived a life dominated by one side and not the other.”

And he paused and looked at me, and when I asked how it felt when I said that, he said he didn’t know what that question meant. He said that for his whole life, people have asked him how he felt, and he had no idea what they were talking about.

Then, he paused again and said, “Maybe before I die, I can learn what that question means.”

It was an amazing moment. I had a feeling from (his statement that) there was some motivation there. He also said he knew it wasn’t right that when people got ill, he felt nothing. So, he had an idea that people are supposed to feel things, and we started on this journey of focusing on right hemisphere processes.

Now, you can’t overwhelm someone who has had over ninety years of nothing developed, but since I knew neuroplasticity as a real thing, and I told him this, I thought if we could drive energy and information flow through the right hemisphere of his brain, over a three to four month period, I believed we could get new synapses to form there that had never formed before. That’s what I told him.

Dr. Buczynski: How did you do that?

How to Stimulate Neuronal Activation and Growth

Dr. Siegel: Well, the first thing is you study what the right hemisphere specializes in, and as I mentioned, it’s an integrated map of the whole body. Let’s start there. That’s a pretty neutral thing for someone that didn’t appear to have any sexual or physical abuse, which he didn’t have.

So, I gave him these “new lenses” to get a sense of his own body. Even before that we did other exercises.

The right hemisphere also specializes in nonverbal responses, So what I did with him was this: I would make a face, and he would imitate it—not name it because that would be bilateral integration, and we wanted to get his right hemisphere going—and the right specializes in facial imitation and recognition. So, I would do an emotion, and he would show it.

“He knew it wasn’t right that when people got ill, he felt nothing. So, he had an idea that people are supposed to feel things, and we started on this journey of focusing on right hemisphere processes..”



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Then, he would do it and I would imitate it. It kind of became fun actually, like a game. So, for homework, because it’s always good to give people homework, I would have him watch television shows with the sound turned off, so that his left hemisphere, which soaks in language wouldn’t get stimulated. The right hemisphere had to start watching the shows, and he had to get his right hemisphere to work.

Then, when he’d get back in the office, we’d do more body focus, like a body scan basically. I then started to work on autobiographical memory. And I want to say that the body scan, an integrated map of the body, is different than the fact that your right hand sends data to your left brain and your left hand sends it to your right brain. Of course, that crossover exists.

But an integrated map of the entire body is only in the right hemisphere. So, with that body work, of course, he was getting aware and doing nonverbal signals, and then what I did for his autobiographical memory is, even though he didn’t have autobiographical memory from his childhood, my sense from studying this for two decades now, is that people never get autobiographical recollections of something… they probably just didn’t encode because it wasn’t emotionally rich.

So with him, I said, “Let’s just talk about today. Before you came to the office, you woke up. How did you wake up?”

He said he got up, he had breakfast, and he got in the car. I said okay, fine, let’s back that up, which foot got out of the bed first?

So, he had to now go from factual memory to having a sense-of-self in time. That’s a right hemisphere specialty, which he wasn’t good at.

Obviously your sense of self, if you don’t even have an autobiographical sense of self is pretty thin, which was basically throughout his whole life. Now what would happen is you would say: hold on, my left foot got up, and then I had breakfast. How? You didn’t fly to the kitchen…Well I went to the toilet first, then I washed my face, then I took a step, etc…all these things.

He would then start making a map of what he experienced that morning. And over time with autobiographical memory, exercises, nonverbal exercises, bodily exercises, and starting to then name feelings, we would put on facial expressions of these feelings, and then he started to change. It was actually quite startling.

Dr. Buczynski: So what would you see?

Dr. Siegel: There were a couple of things you would see. I think one moment is telling, and I think I talked about this in the book. He had mentioned that his brother had lost his leg in a skiing accident, but it didn’t matter, you know, because of his kind of dismissal of relationships or things happening. He knew the facts of it, but not the feelings of it.

“Over time, with autobiographical memory, exercises, nonverbal exercises, bodily exercises, and starting to then name feelings, he started to change.”

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So, one day a few months later, he was saying something about his grandchildren going skiing, and I thought there was something related to his brother losing his leg in the accident, so I brought it up and he started to get tearful. And I looked at him and I asked him if it was something about his brother. And he looked at me and said it wasn’t about his brother, and that we had resolved that.

So, I asked him what he was feeling and he looked at me and said that he couldn’t believe that I had remembered what he’d said, and that I really knew him. You know, and there was this shift of the feeling of his presence in the room. And he began to be able to articulate that he felt sad, that he could feel heaviness in his chest, and that he was aware of his body in new ways.

His son reported that his presence around his grandchildren really changed. There was even one time Stewart came in and told me that I wasn’t going to believe what happened. He said they were saying goodbye to some people, and his wife put her hand on his shoulder, and he told her it felt good. I asked what happened next and he said that she asked him if he wanted a back massage because in sixty-five years of marriage, he never let her do that. And then, she gave him a shoulder massage, and he said it felt fantastic. I asked why he’d said no for sixty-five years, and now at ninety-two, he said yes.

He said that he had been so terrified his entire life of needing anyone because he was never able to need anyone in his childhood, and that now he felt as if he could be that vulnerable to his wife and he could say that he needed her.

His wife actually called me and asked me if I had given him a brain transplant because he had become such a different person. Even at the end of our therapy when he was all done, and he wrote me a note for the holidays, he said thank you for everything and that I wouldn’t believe how much fun he was having in his life.

So, it wasn’t just that he was more present with relationships, internally, he felt this sort of playfulness. So, that’s how we could tell that something shifted with him. It was incredible and I have to say if it were just Stewart, I’d feel really nervous about reporting such a thing in a book, but I’ve worked with a lot of people with avoidant attachment histories, who as adults have dismissed attachment with the same paradigm, and it comes out the same way almost every time. It’s incredible.

“He began to be able to articulate that he felt sad, that he could feel heaviness in his chest, and that he was aware of his body in new ways.”

“You focus on what wasn’t developed or differentiated, and then you can promote the linkage. That’s where the differentition happens, and the integration is basically what comes with creativity and playfulness.”



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So, you focus on what wasn’t developed or what wasn’t differentiated, and then you can promote the linkage. That’s where the differentiation happens, and the integration is basically what comes with creativity and playfulness.

Dr. Buczynski: Let’s talk about how mindfulness can amplify neuroplasticity.

How Mindfulness Can Amplify Neuroplasticity.

Dr. Siegel: Well, you know, neuroplasticity in general, is enhanced by a couple of things. It’s enhanced by aerobic exercise, so, pumping your heart, getting sweat going—all the studies show aerobic exercise is very important.

And interestingly, in one study by Rusty Gage (Fred H. Gage, PhD - Salk Institute for Biological Studies), he says that exercise has to be voluntary. You can’t stick rats on a wheel and make them exercise, and they actually grow their neurons. They have to do it with voluntary effort. That’s the first thing.

The next thing is, of course, good sleep helps consolidate memory, and especially for adolescents. They’re just not getting enough sleep, most of us don’t. Exercise, sleep, and some people say diet. I don’t know what the research really shows on that, but people talk about Omega 3, and we should really be open to it, but I’m not really all that familiar with the controlled studies. So, people throw it (diet) out there, but it’s a question mark.

The next two things are really important. One is called practice. You develop myelin for sure, and you reinforce synaptic connections through practice. And there are all sorts of fascinating studies. There is a beautiful book by Dan Coyle called The Talent Code that looks at how the deep practice of facing the difficult areas can actually grow myelin and develop skills. So, with mindsight skill, the production of neuroplasticity, we really want to look there.

The fifth thing is probably…the most important one, which is the close paying of attention. And in Norman Doidge’s fantastic book, The Brain That Changes Itself, he reviews the studies, which show that when you focus attention, it does a couple of things. Certainly in mindsight, I talk about this at length: where your attention directs which neurons are going to be firing.

The old adage is neurons that fire together, are wired together. Attention, in one part, is the specificity of which neuronal connections you want to get firing, so then they can strengthen their wiring.

So here, what we’re really talking about is the notion for integration of promoting differentiation and then linkage. Attention is a specific flow of energy and information which harnesses neuroplasticity in specific ways. That’s number one. In our view, it’s toward integration.

“Neuroplasticity in general, is enhanced by aerobic exercise, good sleep, and some people say diet.”

“The next two things are really important: practice and close paying of attention.”

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Number two, the other aspect of attention that is really important is that you can’t have distractions. So everyone is busy multi-tasking and all this kind of stuff. I mean, I see people who are at dinner with each other on their cell phones. I mean, you have four people at dinner together, who are all on their cell phones. They’re not talking to each other, or they’re only talking a little bit and doing other things.

We know from research that close paying attention does two things. In a localized way, the neurons which are firing at the same moment, have a local bathing in BDNF, and BDNF enhances the way the genes will be expressed to allow those neurons that are firing at the specific location to actually reinforce their synaptic connections to each other, or make new connections—that’s number one.

But then there’s a part of the brain just above the brain stem which, when you pay close attention, squirts acetylcholine generally throughout the brain. It’s the brain’s way of saying something is important and it’s going to pay close attention. And to actually make this close attention pay off, it’s going to secrete a acetylcholine on top of the BDNF that’s secreted locally so that it really boosts up the neurons that are firing and will be more likely to activate the gene that then allows protein to be produced to allow the structural connections to be made.

So, close paying attention is a very important thing. A third layer of attention, besides specificity and the close paying of attention, is something called mass practice.

If you have a client coming in once a week, that’s fine, but we ought to be giving our clients homework. They need to be repeating the neuron firing patterns that we’re trying to reinforce. So, I think we need to rethink, in general, psychotherapy, the notion of giving practices.

So, when it comes to your question about mindfulness, I think mindfulness is a huge area. If you just look at it as the practice of being aware of the present moment with what’s called discernment, which means you don’t get swept up by judgment, you’re not swept up by thoughts and preconceived ideas, you’re really there in the moment. That’s basically a general definition of mindfulness.

Then, when you do a mindfulness practice, you are having the close paying of attention, and if you’re doing a practice where you’re generating self-compassion, like Paul Gilbert beautifully writes about in his book, The Compassionate Mind, you’re actually turning on the circuits of self-compassion.

“Attention is a specific flow of energy and information which harnesses neuroplasticity.”

“We ought to be giving our clients homework. They need to be repeating the neuron firing patterns that we’re trying to reinforce.”



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So I believe, very deeply, that mindfulness is more than just attention training, and it is attention training, I think, that’s more than just emotion regulation training.

I believe mindfulness is a relational process where you’re altering your relationship with yourself, and in doing so, you’re actually harnessing the overlapping circuits which are both social circuits and regulatory circuits. That’s the key secret if you will. The

secret ingredient is that the social circuits of the brain are pretty much the same as the regulatory circuits of the brain. Once you embrace that reality, then you have this incredible moment where you can say, “Okay, I got it.”

Therefore, if mindfulness is a way of becoming your own best friend, you’ve now totally altered your regulatory functions because you’re now generating self-compassion, which by the way is the gateway for generating empathy for others which is what all the research for mindfulness shows.

You build up fibers. These fibers happen to be the integrative fibers of the brain. They’re literally extending out to long distant areas of the nervous system itself and pulling them together as a whole—which is a whole other story I talk about in the beginning of the mindsight book, but basically, neuron integration, I believe, is what mindfulness promotes.

Dr. Buczynski: I wish we could stay on that longer because I felt there was a fascinating connection or description of why mindfulness is connected to neuroplasticity, but you’ve also talked about the hippocampus and how it can be utilized to heal trauma and PTSD and I’d really like for us to squeeze a little bit of that in here, too.

How the Hippocampus Can Be Utilized to Heal Trauma and PTSD

Dr. Siegel: Sure. Well the hippocampus is just a fascinating area of the brain. A study out of UCLA showed that with people who do mindfulness meditation, they actually have more robust activity in the hippocampus as well as the orbital frontal region, which are two extremely integrative regions. When I say integrative, let me be really clear. I mean super-specifically, scientifically grounded in a very clear definition.

Integration, and integrative circuits in particular, is about a process, and these are circuits which take widely separate and differentiated areas and link them together. So we’re being really specific about the use of that term.

“Mindfulness is more than just attention training...mindfulness is a relational process, where you’re altering your relationship with yourself, and in doing so, you’re actually harnessing the overlapping circuits which are both social circuits and regulatory circuits.”

“Neuron integration is what mindfulness promotes.”

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So, in the work of the hippocampus, for me, it’s basically how I got started almost twenty five years ago now, looking at some of the studies of the hippocampus, and how it could inform our understanding of PTSD. So you could predict in the formation of changes in synaptic connections, which is basically what memory is, that don’t involve the hippocampus, you lay down what’s called implicit memory.

These are like the puzzle pieces of what you see if a dog is running after you. You see the dog. It’s a perceptional memory. If the dog bites you, it might be the feeling in your hand of the dog biting you. The feeling of fear and terror you might experience as well as pain and emotions that come up, the bodily sensations, even your behavior to run. The hippocampus is not involved in any of that.

So you may ask: what is the hippocampus for? The hippocampus appears to develop well enough by eighteen months of age and continues to develop as we develop memories by linking those basic puzzle pieces as I mentioned of implicit memory together. And the key thing is when the hippocampus does do that, the left hemisphere is dominant for factual memory, and the right is dominant for autobiographical memory, which is sometimes called episodic.

So, in the view of the hippocampus and trauma, for example, if you dissociate and focus all of your attention on flowers while the dog is biting you, you won’t encode through the hippocampus the dog’s bite, but implicitly you have encoded the dog’s bite. Now, that condition of divided attention is one way you can block the hippocampus.

The second way is if you massively secrete cortisol stress hormone, at the same time you’re secreting adrenaline. Here’s what happens. Cortisol, in high amounts, shuts off the hippocampus temporarily. Over the long run, it can actually kill hippocampus cells. In the short run, it’s going to shut off the hippocampus.

But adrenaline increases the synaptic changes in implicit memory. So what we’ve basically just described, which I think is a very useful vision for PTSD, is a model for explaining flashback of phenomena, because here’s the deal: when an implicit memory is reactivated without any explicit elements, the hippocampus hasn’t been involved to experience these things in awareness. So it’s not the same as unconscious memory or anything like that. These are elements encoded, stored and now retrieved into awareness, but when they’re implicit only, they have no tagging that they’re coming from the past.

So, this model of the hippocampus role…memory and coding and storing and retrieval is a very useful model for taking apart the various elements of PTSD and also guides us on how to use focal attention to harness the power of the hippocampus as an integrative structure, to actually take those implicit puzzle pieces of memory and perception, bodily sensation, emotion, behavior and even what are called mental models and some called priming, and link them together. In a way, you can describe the resolution of trauma as the integration of previously nonintegrated elements of memory. And then you have the whole model that comes full circle.

“A study out of UCLA showed that with people who do mindfulness meditation, they actually have more robust activity in the hippocampus as well as the orbital frontal region.”



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So, you can describe what the difference is in the brain of a person with unresolved trauma verses the same person who’s now going through effective psychotherapy, whatever sorts it is. And now that they’re resolved, what’s the difference in their brain?

I would have you consider that it’s the integration that’s different. Unresolved equals nonintegrated and resolved equals integrated.

So that’s the model and there are steps, of course, that you can use as a therapist to very practically apply this, to know how to wind your way through the incredibly difficult and often painful depths that are necessary and can be done more effectively with this model in mind.

Dr. Buczynski: Can you outline them briefly?

Dr. Siegel: One thing is just to say that awareness is an extremely important part of our tool kit in psychotherapy. Giving people the strength to be aware of their bodies before they’re going through awareness of their memories, giving them a safe place imagery for example…realizing that awareness is dyadic, and this comes from my history as an attachment researcher. When there’s shared awareness, the degree of complexity, as we say it mathematically, that’s attained with shared awareness alters the way something can be within mental space.

So in other words, shared mental processes have a different trajectory then ones that are experienced alone. That’s the first step. Then, when you can use awareness in a dyadic way that is shared with your client, two tracks have to happen simultaneously, so it’s called a duel focus of attention.

One is, there needs to be a track of the client with you…your relationship staying in the here and now. That is absolutely essential. And then another track, and this is the duel part, is exploring the texture of internal neuronal firing patterns basically which come up as implosion recollections, and at one point a person diving into that is flooded with a flashback and feels as if the dog attack from before is at the present moment. But the difference now is, with dyadic awareness of your relationship, you now can do what my memory mentor, Bob York, calls using memory retrieval as a memory modifier.

So while one foot is putting the toe into the feelings of implicated reactivations, which you’ve explained to the patient, and you have them understand, the client really knows that it’s going to feel like it’s happening at the present moment, but that’s just the way the brain works when it’s not integrated.

“This model of the hippocampus role...memory and coding and storing and retrieval is a very useful model for taking apart the various elements of PTSD and also guides us on how to use focal attention to harness the power of the hippocampus as an integrative structure...”

“Unresolved equals nonintegrated and resolved equals integrated.”

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They’re also now dyadically with you, and you can have them control that in all sorts of ways…for example: using images of a file cabinet and a file room and being the only person who has the key. And in doing this, you’re basically taking before (which was an out of control, overwhelming event, the trauma) and you’re teaching them mindsight skills to track energy and information flow in your relationship, mental experience, and the brain itself.

And as you track what’s going on, you can transform it. And this is where, for a therapist, when you’re understanding what you’re trying to do, in terms of neuronal integration, you’re giving a pathway, and then as you go through all the pain, you know where you’re headed, which is basically to link these previously unlinked differentiated isolated elements of explicit memory.

Dr. Buczynski: I’m so sorry that we’re out of time because there’s so much to cover here. This book is rich and full of clinical application that I know any mind and body practitioner would find useful. Thank you to everyone for being on the call tonight, and especially to you Dan. This was an enlightening hour.

“As you go through all the pain, you know where you’re headed, which is basically to link these previously unlinked differentiated isolated elements of explicit memory.”



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About The Speaker:Daniel J. Siegel is currently a clinical professor of psychiatry at the UCLA School of Medicine where he is on the faculty of the Center for Cul-ture, Brain, and Development and the Co-Director of the Mindful Awareness Research Center. He is also the Executive Director of the Mindsight Institute, an educational organization that focuses on how the development of mindsight in individu-als, families and communities can be enhanced by examining the interface of human relationships and basic biological processes

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