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Comment by jkhdigital | Hacker News Reader

Man, I love seeing more research like this. My personal experience, as someone who has dealt with a variety of issues in psychiatrists' offices and rehabilitation rooms, is that a clear scientific understanding of what is actually going on under my skull provides a much firmer basis for any therapeutic approach. I'm really hoping that in my lifetime we will see connections made between the physiological elements of consciousness and the modern psychiatric plagues of depression, anxiety, and addiction that finally produce the targeted, universally effective therapies that are desperately needed.

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I was recently talking to a registered psych nurse, and we got talking about Cognitive Behavioural Therapy.

I believe I've been self administering a form of it for a couple years, and I summarized my understand of CBT as "moving more thinking from the amygdala to the prefrontal cortex", and she confirmed that with "in laymen's terms; yes".

It's not like the fields are completely isolated, I guess is what I'm getting at with that anecdote. It's hard to go from neuroscience to psychology, but that's always being looked at. I reckon most big advancements will start coming when we start understanding the connectome more, but it's not like all advancements will come from there, and it's not like people aren't working right now to bridge neuroscience and psychology.

Also I want to hang out with the laymen she does.

Do you mind sharing your approach to how you make that shift from "amygdala to the prefrontal cortex"? Is it similar to practicing mindfulness with a focus on the now?

No, prefrontal cortex is about planning, reasoning and inhibiting emotions (we do it all the time without realizing) among a lot of other things. Amygdala is based on reacting to fear, among other emotions.

CBT gives you a toolset to ask yourself questions to understand (a) which perspective you're currently looking things from and (b) which other perspectives you could use.

The 10 cognitive distortions and recognizing them is a good start. Cognitive distortions happen mostly through emotional processes (e.g. the amygdala but the whole limbic system really).

Mindfulness meditation is an emotional-based approach as it mostly relates (for laymen like me) to scanning the body. Scanning the body gives marked improvements to the insular cortex. It also gives marked improvements to the PFC (the inhibition part, not the planning part).

This is all written way too short and my knowledge is a bit stale on it. I used to be really into this a couple of years ago. It was during the time when I studied psychology (I even published a neuroscientific literature review :D).

I love the spirit of your response, but I feel the need to disagree a bit and elaborate about your statement: >Mindfulness meditation is an emotional-based approach as it mostly relates (for laymen like me) to scanning the body

The REAL essence and power of mindfulness is becoming aware of the contents of your attention. For some reason, focusing the attention inwards on bodily somatosensory experiences tends to encourage that, but the two are not the same. Body-scanning is more a technique to help encourage the development of mindfulness rather than the end goal in itself.

The reason this distinction is so important and powerful is that the brain regions which are feeding the contents of your attention are the ones that get reinforced. When you combine mindfulness with practice in redirecting your attention, it becomes an insanely powerful tool to fundamentally reshape your reality by restructuring your brain.

Yes exactly. The "mindfulness" designation is a recursive one, where first you are mindful, then you are mindful of that which is mindful, and all the way down.

Until you find the first turtle, then it's turtles all the way down.

I will send turteCore, but you have to ask for it. Ribbit.

My problem with these terms is there's no chance of not being mindful. It seems to refer at once to both immediate awareness of surroundings and kind of meta self-awareness. You're in the present moment no matter what you do but redirecting focus seems to help get a grip on emotions.

There's some irony there given that excessive body-scanning and hyper-vigilance can be common symptoms related to anxiety.

Though the CBT stuff in general and being aware of your attention does seem empirically helpful, I just find the body scanning focus as a common start may not be the best.

The primary difference is that the kind of awareness cultivated during meditation is non-judgemental. Mindfulness helps put thoughts into perspective, where you can observe them rather than feel absorbed by them. So in this sense you can pay attention to your body without getting carried away by the stream of anxious thoughts.

And therein lies the difficulty of the process: shifting towards objectivity, in a sentient being that is primarily (if not entirely) a subjective experience. I appreciate CBT, but often feel saddened to see that this doesn't get addressed in most of the resources attempting to educate about the practice.

"Mindfulness and psychotherapy" (by Germer, Siegel, Fulton) has helped me with these issues by giving multiple perspectives on the process to develop. It's a book for therapists, which is one of its strengths, since we essentially are trying to get people to sustain being their own therapists in the long run.

Could you expand on the "practice in redirecting your attention". What kind of practice you do? Thx!

I'm not the person you replied to, but you might want to check out The Mind Illuminated by John Yates, a modern meditation guide (based on Buddhist practices) that delves deeply into mind's systems of attention & awareness.

> Mindfulness meditation is an emotional-based approach as it mostly relates (for laymen like me) to scanning the body

Just to clarify, body scanning is just one type / approach to meditation. Many practices don't utilize it at all, or only do so in conjunction with other techniques.

I appreciate the clarifications. I did write it a bit too hastily. Sorry about that.

There are some studies that seem to indicate decision making is inhibited when emotions are inhibited. That is, you can ask someone to explain what the rational choice is, and justify it, but they will not actually make that choice until an emotional prompt spurs them on. They can be very, very good at planning extensively but won't take action. The study I'm thinking of was on brain-damaged patients without emotion but perfectly intact reasoning.

So I wonder how that fits in with what you've experienced. Is analysis through CBT in fact opening up new information to change how you feel about certain things (rationality induced emotion, spurring change)? Or perhaps I am misunderstanding the conclusion (I've seen it presented as such elsewhere so I'm not the only one).

> His insight, dating back to the early 1990s, stemmed from the clinical study of brain lesions in patients unable to make good decisions because their emotions were impaired, but whose reason was otherwise unaffected

https://www.technologyreview.com/2014/06/17/172310/the-impor...

I'm not qualified to contest this, but I do remember a side blurb from "Principles of Neuroscience" (Kandel, Schwartz, Jessell) that said overactive mPFCs are attributed with autism and below is some more research on it.

I don't think you're saying this overtly but I have seen people from the Thinking Fast & Slow crowd glorify their PFCs as arbiters of cognitive bias while forgetting that healthy social, emotional processing required integrated functioning between all neural correlates involved, including the amygdala. I would venture to guess CBT is effective because it stops overactive PFCs which is the opposite of what the nurse's guess is. But as a laymen here, I can't say one way or the other.

I remember a decade or two ago, the ACC+vmPFC combo was getting a lot of praise as this balancing force between the dlPFC and the amygdala saying strong ACC+vmPFC could be the clue to healthy brains. I think the answer will always be, "hey all these parts are important. Just meditate, exercise, and eat right. And don't believe your thoughts too much (CBT)"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5192959/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688328/

As a depression patient, that's more or less healed, here's my take: - In depression you can get up lost in these cognitive negative loops

- One of the feedback loops is between what you feel and what you think - a bad feeling induces you to think some bad thoughts, and as those thoughts are combined with the bad feeling, they are validated as true. Now the thought is associated with a bad feeling, and one will give rise to the other , just like tinkle of the bell induced pavlov's dog to drool. But in this case the drooling of the dog can also make the bell tinkle, causing more drooling...

- the amygdala response is about the bad feelings, and how the bad feelings can induce more physiological discomfort due to amygdala kicking in and doing "what it's supposed to" - now your bad feelings are superchardged as well

- so, I would say it's not only about cortex or amygdala, but in depression the negative thought patterns and the physiological response can get linked into this destructive loop of continuous feedback. Hence, it does not matter that you can rationally say to yourself the bad thoughts you had are not that serious because they just launched a full scale amygdala based storm of bad feeling and anxiety

- my ssri:s kind of felt like they cut out this bad loop. I felt like my cognitive self was insulated from the physiological response, giving me space to unlearn both cognitive and emotional bad habits one at a time without the disruptive loop taking control

Funnily enough, many combat vet friends of mine have had the most returns from two things which both seem to affect the brain in the same manner: cannabis and CBET.

On the former, I can't recall who at the moment but there is significant research that has shown the primary cause of cannabis being so well received by those with ptsd is that is reduces amygdala activity and increases pfc activity.

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