Interview with Dr. Sara Lazar

Transcription

1 Interview with Dr. Sara Lazar Dr. Sara Lazar is at the cutting edge of research into the affects of meditation and yoga on brain activity and changes in brain structure. She has made breakthrough discoveries using neuroimaging to examine the impact of meditation on brain activity and structure. Dr. Elise Bialylew: Thank you so much, Sarah, for being on the program. We really appreciate your time and the listeners are in for a real treat, because some of the research you have been doing is groundbreaking. Just to give a bit of a context for listeners, would you be able to give a very brief sense of who you are and what your work s been in the world. Dr. Sara Lazar: Sure. Thanks for having me on the show. My name is Sara Lazar. I m a PhD researcher from Boston, Massachusetts. My research is on the beneficial effects of yoga and meditation. And, specifically understanding how they work from the brain perspective. So, we look at the brains of people who do yoga and meditation. Dr. Elise Bialylew: Great. Can I ask you, are you personally a meditator? Dr. Sara Lazar: I am. I have been meditating for about twenty years now. Dr. Elise Bialylew: A question that I like to ask all of the guest experts is why do you meditate? Dr. Sara Lazar: Stress reduction. It s fantastic. I mean not just that. But, I got into yoga actually as a former physical therapy. Even before that I thought it was all a bunch of nonsense. But, I started doing yoga as a form of physical therapy and then really appreciated all the benefits - so the stress reduction and the emotional regulation in general. But, also there s other benefits. Even when you re not stressed, it s just more relaxed and a different world view, and just more in tune with a lot of things that I wasn t so in tune with before. Dr. Elise Bialylew: Can I just dive a little bit deeper there because I m very curious to know what you mean by a different world view and being in tune with things that you might not have been in tune with before, if there is anything more you could share about that? Dr. Sara Lazar: Yeah. For me, a lot of it had to do with picking up on cues from other people. So, just being a lot more aware of other people s emotions. That s something that I wasn t very good at before and I m much better at it now. And, being able to see things from other people s point of view. Also, just little

2 things during the day. Just stopping to smell the roses. Taking time out to notice, Oh isn t that a nice flower or the sunshine is really beautiful today. I mean, you notice it all the time, but I just found myself doing that more. And just pausing during the day a little bit more to appreciate the small things in life. Also, when things are sort of crazy and out of control, being and having that perspective of okay, but right now, I m okay. Like, right now, yes everything around me is kind of crazy but I m okay. And being able to really stay grounded in the present moment when other things are a little bit nuts. Dr. Elise Bialylew: To sort of finding an anchor to sanity in the midst of chaos and insanity. Dr. Sara Lazar: Exactly. And that s really what it s about. It s just not getting so personally involved in things and being so caught up in things, and being able to just be okay, and sort of step back for a minute. Then, when you do that, when you re not all caught up then you start to notice more and more about the whole situation. Like, what everyone else is talking about and it opens things up. Dr. Elise Bialylew: A lot of people that aren t meditators wonder why would I bother doing something that is so passive?. What has been interesting is just speaking to a lot of people like yourself, other experts in the world, like I imagine you re a super busy person, the work that you re doing, yet you re also a meditator. And, so this idea of how a practice that s about stillness, pausing, can actually help someone who is so active in the world. Is there anything you could add to that from your own experience of this kind of paradox Dr. Sara Lazar: I think for a couple of different ways because first of all, you can t do everything, right? And that s why we get stressed, because we try to do everything. You need to learn how to say no and I think that s really part of what meditation is about. It is understanding what your limitations are. Understanding what s important for you. Understanding that if you say yes to this really cool thing that it s going to drive you nuts. And later, maybe, say yes to that but then, you need to say no to something else. Again, that s part of the perspective that you gain with the meditation. I mean, you get that through experience anyways. But, I think it helps you check in and assess things a little bit more easily. And also, I think you re able to do more because of the stress reduction. So that you don t get overwhelmed. I feel like I can handle more now because no one thing is going to knock me over so much and because I m not so much invested in this one little thing because I can keep my perspective, I can juggle two or three more things that maybe I normally wouldn t have. Dr. Elise Bialylew: Thanks. So, moving on to the topic of mindfulness. There are many different definitions; everyone sort of seems to come up with their own feeling or sense into it. What s your perspective on what How do you encapsulate mindfulness? Dr. Sara Lazar: Mindfulness is awareness without being judgmental. So, with evaluating but not being invested in how things are and recognizing that however things are, I m still okay. Can you find that place where you re okay regardless of how things go and things just as they are? Dr. Elise Bialylew: What you re saying is that can you be okay as things are, but not in a passive resigned way, that you re to take action if you can. But, just to be able to find a space where you re okay.

3 Dr. Sara Lazar: Exactly. So, one of my teachers I love this quote she said, You re not trying to quiet the storm. You re trying to find the quiet within the storm. Which I think is really wonderful. And that s the mindfulness. It is sitting there, watching everything go around you, and all the craziness, and just being able to find calm and be centered and present. Dr. Elise Bialylew: So, I d love to dive in to some of your research because really I mean your name is quoted in so many different places. It s really exciting. So, could you share some of the groundbreaking research that you have done and can you speak to some of the brain parts because we love that? And just clarify very briefly what these parts of the brain do. Dr. Sara Lazar: The first study we did was we took long term meditation practitioners and we scanned their brains, and we compared them to people who were matched for age and gender and education, but who had no previous yoga and meditation experience. And, we found that there were several brain regions that were different between the long-term meditators and the controls. And, these were areas of the brains that were important for emotions and also for sensory perception, particularly being aware of the internal sensations. That was one of the key regions that we found different. But there were a lot of critics to that first study because a lot of people said, well, people who meditate are different. So, maybe the brains were a little bit different even if they didn t meditate. You can t really tell that. So, then the second study we did was we took people who had never meditated before and we randomized them. So, half the group went through an 8-week meditation program and the other half we just scanned 8 weeks apart. So, these were people who were interested in the study but we told them they had to wait. So, then after the eight weeks were done and we scanned them then they went into the class. So, they were just like other people but they were 8 weeks behind the first group. And, that was important because then what we saw there was actually change in their brains over the course of the 8 weeks in the people who went to the meditation group, compared to the waitlist controls. So their brains didn t really change, whereas the meditation group, their brains changed quite a bit. The regions we found changing over the course of the eight weeks were very interesting. The first region that we found to change over the course of eight weeks is a region called the posterior cingulate (PCC). The posterior cingulate is important for the sense of self and mind wandering. When you re on a task and then your mind starts to wander, it s because of the PCC. It is going and being active. Sometimes more grey matter means more activity and sometimes more grey matter means less activity. Just means the change in how that region is regulated. And, so we think that because when you meditate your mind wanders less, the more grey matter in this brain region correlates with the mind not wandering so much. The other region we find changes in is a region in the brain called the hippocampus. The hippocampus is very important for learning and memory. We found that that got bigger and that suggests that this is helping improve memory and learning. Another region we found is called the Amygdala, which is the main stress and fight/flight part of the brain, and it got smaller. The change in that correlated with reduced stress. So, the more stress reduction there was the smaller the Amygdala got. And, so this is really consistent with other research that has been done.

4 Dr. Elise Bialylew: So, just taking a pause to kind of take all that in for the listeners. So, this is really all related to the concept of neuroplasticity, right? Dr. Sara Lazar: Yes. Dr. Elise Bialylew: So, can you define how you understand neuroplasticity? Dr. Sara Lazar: Basically, our brains are very plastic. And, what that suggests is that the brain is constantly remodeling itself. Every time you learn a new piece of information, the brain is plastic, it s taking that information and it requires the neurons to fire in a different way than they did before you knew that information. You re asking a very important question. So, neuroplasiticy is not something specific to meditation. If you were to take on any new task, your brain will change in the areas that are important for that region. So, for instance the first study that looked at this, they took people who had never juggled before, they scanned them and then they taught them how to juggle and they had them juggle for three months. Then, they scanned them a second time. They found that the area of the brain that s important for detecting visual motion got bigger in the jugglers, which makes a lot of sense. They ve been other studies with a bunch of other different types of tasks that are showing that the brain region which is important for that task change over the course of two or three to four months. Similar in animal studies, you can take animals even over a course of a week; you are going to find changes in brain structure in week. So, it s not so much that the brain changes, but for us, it s more where it changed and that gives us important clues on what s happening. Dr. Elise Bialylew: Thank you for clarifying that. The interesting thing here is your point about where it changed. Is it something about as parts of the brain change in an enduring way that gives more capacity to that part of the brain to function? Dr. Sara Lazar: Exactly. And that s the idea because often people say that when you meditate it feels great. But, it s really how it impacts you during the rest of the day. That s often why people continue practicing. It s because, similar with exercise, lots of times people tell you I know I didn t exercise today my body doesn t feel right because I didn t exercise today. Similarly, people who meditate regularly will tell you, Yeah. I m not just quite the same on days when I don t mediate versus the days I do mediate. And, we think that s part of it - this change in world view and being able to stay calm and centered. Those changes in the brain happen because of the meditation, which help those different changes in the changes in emotions and reactivity even when you re not meditating. Dr. Elise Bialylew: With the juggling example you gave, it s nice to be better skilled in motor hand control, or whatever. But, it s profound to be more skilful at tuning into what s going on the inside so that you actually have higher connection with emotional activity. Then, that s actually going to profoundly impact your relationships. So, it seems to be the relevance here is that it s the parts of the brain that are being affected by meditation and the role that those parts of the brain have in our lives to enrich in our lives in particular ways around emotions and attention. Dr. Sara Lazar: Exactly.

5 Dr. Elise Bialylew: What are you focused on now? Where is your curiosity about this area of research in meditation in particular? Dr. Sara Lazar: The brain changes are consistent with the known effects of meditation. But, now we are trying to really connect the dots to show that, the change in the Amygdala really is related to changes in stress. So, for instance, we just finished another study and we don t have the results yet but we looked at cortisol (the stress hormone) and we gave them some stress tests. So, this idea is to see that, okay, well do the people with the smaller Amygdala really have less stress by something other than self report. The hippocampus again is the memory part of the brain. So, doing some memory tests, and some mind wandering tests. So, we are trying to get at the known functions of these brain regions to confirm that yes these changes in brain structure are actually doing something, the things we think they re doing. Then we also very much want to start looking beyond two months. So, what happens is if you continue practicing, for say six months or a year, a little longer term. Dr. Elise Bialylew: This is relating to people that have been meditating that are newer perhaps to meditation that have been doing the 8-week mindfulness training that requires like 30 minutes of practice a day, is it? Dr. Sara Lazar: Yeah, 30 to 40 minutes. They are told 40 minutes a day. On average, the subject on our study practice is 30 minutes. But there are some people who practice 40 minutes and some people practice 20 minutes. That s always a question I get - how much do I have to practice? And the short answer is we don t know. Some teachers say like even ten minutes a day is great. For me again, exercise is a great analogy. It s all good and the more you do the more you can get out of it. But, the general idea, specifically, if you can even do ten or fifteen minutes several times a week, that s a pretty good thing. And again, as you start practicing you ll see. Dr. Elise Bialylew: Coming to the end of the interview, I like to ask people what books they have read personally that affects and impacts on their thinking or inspired them in some way. It could be any kind of book. Dr. Sara Lazar: Yeah because I m thinking like all the things I read recently are not for the beginners. Dr. Elise Bialylew: That s actually okay because it s sort of an offering for later down the track as well, because there are people listening that would have had more experience as well. Dr. Sara Lazar: I see. There is a wonderful book called The Satipatthana Sutta. It s out there. It s actually a person s thesis, a German man s thesis. So, The Satipatthana Sutta is one the When the Buddha was alive, he would give these talks to the students and one of the talks he gave was on The Satipatthana, which is about basically how to practice. It s a very famous lecture that he gave.

6 It s really good in terms of practice of like really understanding in a much more detailed way. It s not just intellectually but also a little more experientially. Dr. Elise Bialylew: Funnily enough it s sitting on my desk just over there. I m getting fired up to try and get through it. Dr. Sara Lazar: And definitely, you need to do it in small pieces because it s very dense. But, it s good to like read a little bit and then practice with it a bit. Then, read a little more and practice a little but more. So, definitely that s not something you just go and read within a day and Dr. Elise Bialylew: Just to make the link for people. Like you ve brought up this Buddha s text and how that s relating to mindfulness because, obviously, in the mainstream mindfulness is being secularized so that it s accessible to lots of people. What s your perspective and understanding of how it fits into the Buddhist s context? Dr. Sara Lazar: There s a great debate about all of that. I mean, I guess that sort of feels like classes obviously you can t teach Buddhism in eight weeks. And they are not meant to be teaching that in eight weeks. There s a lot of people that think this is somehow offending Buddhism and I don t think that s the case at all. I think its teaching people the beginning, let s say of meditation, and for stress. And, for a lot of people that s all they want and that s all they need. Then, some people will get excited about it and they re going to go and they re going to look and search for more Buddhism. So, I don t think one shouldn t- if you re offering stress reduction clinic try to make it turn to Buddhism. Those are my thoughts. Dr. Elise Bialylew: Quite a science of the mind, really, a lot of it? Dr. Sara Lazar: Yeah. Exactly. And it s often referred to as Buddhist Psychology because again, it s all about being calm. And regardless of what your situation is, I think it s very beneficial. Dr Elise Bialylew: Just coming back to your research the idea that there is this hint that we have this power to be able to somehow intentionally sculpt our brains by practices that we re doing. And I m just very curious about the area of antidepressants and psychiatric medication and just trying to do stuff like that. But then, we know that there might be these practices that we can actually implement that are in some way doing a similar thing. Dr. Sara Lazar: Definitely, yes. Dr. Elise Bialylew: Can you share your perspective on how you see that? Dr. Sara Lazar: Sure. So the hippocampus and the Amygdala are two prime examples. The hippocampus is important for depression. So, the people with smaller hippocampus tend to have worse prognosis than people with a larger hippocampus. And, so here it is in the meditation research that shows the hippocampus gets bigger. And in depression actually, there's numerous study showing that meditation is effective for helping prevent depression relapse but also possibly improving depression symptoms. So, it does seem like it could potentially have some really beneficial effects in the area of depression, similar

7 with anxiety. There s not as much research but the research that is there, is very suggestive. Then again, the Amygdala getting smaller because the Amygdala is the number one region that psychiatry gets excited about because it s all about anxiety and fear and emotions in general, but particularly anxiety. The fact that we are able to shrink the Amygdala, I think there s a lot of implications for anxiety disorders. Again, this is really just starting but I think talking to long-term meditation practitioners, a lot of them will tell you I used to be depressed, I used to be anxious, I used to be on these medications, and I m not anymore. Not everyone is able to get off their medications, but a lot of them are able to decrease it. I do think it has a lot of implications. Dr. Elise Bialylew: It s incredibly exciting. I just have to tamper my excitement because I m trying to still explore the research and understand really what this means and what the implications are before we all get really excited and go, oh my God, there this is amazingly powerful way that people can be empowered to look after their mental health. Rather than feel that the option is to go and get medication. Dr. Sara Lazar: Exactly. And I should have actually put a caveat to that because there s been too much hype and there are a lot of people like, Oh the meditation cured everything. Because definitely I do also know many long term meditators who are still on medication, I do want to point that out. And that everyone is different so it s not a cure all. Also, it s very good for reducing symptoms but not always completely eradicating them. So, definitely it takes the edge off of things. It helps take things down but, sort of like exercise, I mean, even if you exercise, we are all still going to get old, eventually. There s limits to what exercise can do and likewise there s limits to what meditation can do. Dr. Elise Bialylew: I think that s a very important point. Thanks so much and we ll share links to your research and your website. Again, just thank you so much for your time. Dr. Sara Lazar: Thank you. Okay.