Motivation and emotion/Book/2014/Emotional regulation through meditation

Overview
"there is nothing either good or bad, but thinking makes it so" (Shakespeare, 1603, Act 2 Scene 2, 249-250)



This chapter explores how meditation can be used to improve emotional regulation. It primarily focuses on how meditation activates various regions in the brain and how this effects capacity for emotional regulation. First a description of both emotional regulation and meditation are given separate of each other. The benefits of meditation on emotional regulation is discussed covering some of the more prominent effects followed by some of the major areas in the brain that are activated during meditation and which undergo brain morphology with regular mediation. These are listed and described including details of the typical function each region is responsible for. In conclusion {{grammar]} it is found that meditation has many and varied benefits on emotional regulation, although there is still much to be understood about how exactly this occurs. The vast amount of research on this topic suggests this field will continue its scientific exploration of this area and progress our knowledge over time.

Emotional Regulation
Emotional processing or emotional regulation (ER) relates to the extent of our ability to influence our feelings, reactions and expression of emotion (Szcygiel, Buczny, Bazinska, 2012, p. 433). To assist with regulating emotions, the use of an ER strategy can be used, the purpose of the ER strategy is to influence emotional reactions to internal or external emotional stimulation (Rodriguez, Rey, Clemente, Wrzesien, Alcaniz, 2014, p. 1199). Commonly defined ER strategies can fit broadly into either suppression or reappraisal (of emotion). Studies indicate that while suppression appears to decrease the negative expression of emotion it does not decrease the internal experience of emotion (Krygier et al., 2013, p. 306). In contrast, reappraisal appears to decrease the negative emotional experience and the emotional expression. Results of studies suggest that an increase in physiological reaction and impaired cognitive functioning are associated with suppression but not reappraisal (Szcygiel et al, 2012, p. 433). Gross in his 1998 scholarly paper similarly defined two main types of ER strategies as Antecedent and Response Focused. Antecedent focused ER is concerned with the initial stimulation and processing of emotion before physiological and behavioural reactions occur within the body. Response focused ER refers to the processes undertaken after the emotional reaction has occurred and includes modifying the emotion. (Gross, 1998 as referenced in Szcygiel et al, 2012, p. 433). Chambers, Gullone, and Allens defined ER as "the process of modulating one or more aspects of an emotional experience or response" (Chambers, Gullone and Allen, 2009 as referenced in Rodriguez et al., 2014, p. 1699).

Five Major types of Meditation Practices

 * 1) Mindfulness Meditation: This type of meditation includes Zen Buddhist Meditation, Vipassana Meditation, Mindfulness-Based Cognitive Therapy (MBCT and Mindfulness-Based Stress Reduction(MBSR). It is characterised by practices which emphasise staying in the present moment, awareness, acceptance and non-judgment.
 * 2) Mantra Meditation: This type of meditation includes Clinically Standardised Meditation(CSM), Transcendental Meditation and Relaxation Response. It is characterised by the repetition of sound, phrase or word as the main component.
 * 3) Yoga: This is complex and wide ranging category that involves thousands of different positions and poses referred to as asanas,combined with breathing techniques referred to as pranayama, positioning of the eyes, the use of mantras and meditation techniques including Pratyahar, Dharana, Dyana or Samadhi. Well known practices of this type include Kundalini Yoga and Hatha Yoga.
 * 4) T'ai chi: This type of meditation uses Chinese Martial Arts which incorporates breathing techniques into smooth, slow paced and continuous movements. Mental training techniques are also used throughout the training.
 * 5) Qigong: This type of meditation practice with Qigong; an ancient Chinese activity which involves breathing techniques while doing particular physical poses. It is characterised by the focus on self-regulation and was traditionally used for medicinal purposes.

(Ospina et al, 2008, p. 1199)

Meditation practices have been used for healing for other 5000 years. It has been widely accepted into mainstream medicine as an alternative therapy in the mind-body realm. Meditation is practiced by hundreds of millions of people throughout the world (Ospina et al, 2008, p. 1199). Particular emphasis and importance is placed on developing ER, self-control and adaptability throughout various types of meditation (Fox et al., 2014 p. 63).

Within the broad term "meditation" are many variations of the technique, but some common elements throughout many include:
 * Working with breath
 * Focusing on being present in the moment
 * Focusing fixedly on an object
 * Focus on awareness of the body
 * The use of visualisation
 * The repetitive use of words (mantra)
 * The use of a repetitive action
 * Mental practices including focused attention, labelling and non-judgement mental activity
 * Incorporating sequences of body movements

(Sobolewski, Holt, Kublik, Wrobel, 2011, p. 47)

Two broad streams of meditation practices have been identified; focused meditations and mindfulness meditations. Focused meditations involve concentrating fixedly on a single point (an object, an image or a word) and the continual naming and categorising of thoughts, feelings, events and experiences. The purpose of this practice is to transform from being absorbed in an experience that is happening to you into an awareness of yourself experiencing sensations in a disconnected way, much like an observer. Being able to remove from the emotional influence of the experience allows greater control of emotional and mental reactions (Sobolewski et al., 2011, p. 47). Mindfulness meditation involves maintaining an awareness of the present moment with an accepting, non-judgmental open-mindedness (Fox et al., 2014 p. 53).

The practice of meditation has been associated with many benefits including improved health, well-being and bodily function in autonomic, immune (Krygier et al., 2013, p. 306) and endocrine systems (Sobolewski et al., 2011, p. 44). In addition, cognitive functioning and behavior (Fox et al., 2014 p. 50) are enhanced as well as awareness of self and greater capacity for control and stability of emotions (Sobolewski et al., 2011, p. 44).

What are the benefits of meditating on emotional regulation?

 * Increased emotional awareness
 * Greater capacity for pain and emotional tolerance
 * Reduction of anxiety and stress and improvements in depression
 * Enhanced executive control and cognitive performance
 * Improvements in general health and well-being

(Fox, 2014, p. 48-71)

Increase Emotional Awareness
Emotional awareness (EA) has been shown to be a contributing factor of ER; those who display higher levels of ER are more accurately able to identify their own emotions as well as the emotions displayed in others. This developed ability enables greater emotional self awareness and awareness of other's emotions (Szcygiel et al, 2012, p. 433). Studies show that the more intense the emotion, the less ER a person is capable of. Those who score high in EA however, or successfully utilise the reappraisal strategy, appear to be able to combat the disabling effects triggered when experiencing more intense emotion (Szcygiel et al, 2012, p. 436). The capacity for awareness when experiencing an intense emotional state before it is expressed has been shown to play a role in the ability one has to display greater adaptive behavior (Szcygiel et al, 2012, p. 436). Benefits of long term meditators have been shown to include increased EA (Fox et al., 2014 p. 63). Those scoring higher on a Levels of Emotional Awareness Scale (LEAS) were also shown to have greater right hemispherical brain activity, using this region when analyzing facial expressions to determine the emotion. Those low in EA appear to be less conscious of their emotional states when experiencing more intense emotion (Szcygiel et al, 2012, p. 436). Those high in EA have greater coping and processing ability when experiencing more intense emotion (Szcygiel et al, 2012, p. 436-437). Studies comparing those who practice meditation with those who did not practice meditation found that meditators emotional processing was cognitively different. Meditators were less aroused by negative visual stimuli, while processing of neutral or positive visual stimuli was similar to those who did not meditate (Sobolewski et al., 2011, p. 44).

Greater capacity for pain and emotional tolerance
The experience of pain is influenced by multiple factors such as mood, attention, ER and previously existing ideas of how pain should be addressed/felt/experienced. Through altering the way the brain cognitively evaluates sensation such as pain, meditation can reduce the reaction of pain and how the body feels it as an experience (Zeidan, Grant, Brown, McHaffie, Coghill, 2012, p. 165). Long term meditators have greater ability to monitor pain and studies show that meditators can significantly decrease the experience of pain by practicing mindfulness. Advanced Buddhists have significantly higher tolerance to pain than the normal population (Fox et al., 2014 p. p 63). Chronic pain sufferers who elected to partake in a Mindfulness-Based Stress Reduction program reported improvements in degree of pain felt and quality of life (Zeidan et al, 2012, p. 166).

Reduction of anxiety and stress and symptoms of depression
Meditation has been shown to increase capacity for observing thoughts and emotions while remaining disconnected and emotionally-neutral. It has been suggested that activating the region of brain responsible for this (rostrolateral prefrontal cortex) through meditation practices may improve relapses of depression (Fox et al., 2014 p. 63). The practice of mindfulness and focused concentration appear to be contributing factors in altering the way the brain cognitively processes negative emotion. With mindfulness emphasizing awareness of the self in the present moment and consciousness of thoughts, emotions and physiological state (Sobolewski et al., 2011, p. 47) it's understandable that meditation has also been shown to lower self-report anxiety levels (Sobolewski et al., 2011, p. 44).

Enhanced executive control and cognitive performance
Through executive control, it is possible to overcome automatic responses and impulses. Results from studies show that meditators outperform non-meditators in measures of executive control. For example, meditators were able to complete mental tasks more quickly and with greater accuracy than non meditators (Teper, Inzlicht, 2013, para. 3). This may be due to meditation retraining the brain to accept emotions (as well as attentional focus and non-judging awareness) (Teper, Inzlicht, 2013, para. 1), alleviating the burden of mental incongruence and allowing greater focus. In one study testing cognitive function ability on brain-computer interfaces, those who underwent 12 weeks of meditation practice performed significantly better in accuracy and speed (Tan, Dienes, Jansari, Goh, 2014, p. 12). Studies have shown that meditators have higher Electroencephalogram (EEG) patterns than normal. This has been understood to represent a reduction in "neural noise" (Davidson and Lutz, 2008 as referenced in Tan et al., 2014, p. 13) in meditators. This neural noise reduction appears to enhance brain signal performance and enhance cognitive functioning (Tan et al., 2014, p. 13). Long term meditators have been shown to have an increased ability to implement creativity in problem solving (Fox et al., 2014 p. 63).

Improvements in general health and well-being
Meditation has many well documented and wide ranging health and well-being benefits including decreasing levels and frequency of stress and anxiety and depression, enhancing cognitive functioning and performance, greater control of thoughts and ER, improvements in mood and increased capacity for acceptance (emotional, situational) (Krygier et al., 2013, pp. 305-307). Following 10 days of high intensity Vipassana meditation, participants reported improved well-being on all aspects (Krygier et al., 2013, p. 310). One study found that meditation increased heart variable rates which was correlated to greater experiences of well-being. Compiling studies are finding that practices of meditation are linked to greater cardiac health, as well as autonomic function and overall body health (Krygier et al., 2013, p. 306).

What happens to the brain when you meditate?

 * 1) Sensory Cortices and Insula: Bodily sensations such as pain and touch. Emotional and cognitive awareness
 * 2) Hippocampus:Memory consolidation and reconsolidation
 * 3)  anterior cingulate cortex: Concentrative solving of problems, self-control and behaviors which are adaptive during altering circumstances
 * 4) Mid cingulate cortex: Concentrative solving of problems, self-control and behaviors which are adaptive during altering circumstances, and higher scores in EA
 * 5) orbitofrontal cortex: Analysing stimuli and determining the correct motivational actions ,ER, EA and specifically in lessening reactions and in reappraisal.
 * 6) Superior Longitudinal Fasciculus:spatial awareness and the ability to perceive in 3D.
 * 7) Corpus callosum: Inter and intra hemispheric communication. Acts as an                                                                                                        connection highway for various other regions of the brain including frontal brain areas with visual cortices at the back of the brain.

(Fox et al., 2014 p. 48)

(Ospina et al, 2008, p. 1199)
 * Grey matter regions
 * Anterior cingulate cortex
 * Posterior cingulate cortex
 * Insular cortex
 * Temporoparietal junction
 * Cerebellum
 * Hippocampus
 * Caudet nucleus
 * White matter pathways
 * Superior longitudinal fasciculus
 * Saggital Stratum
 * Thalamic radiation
 * Corona radaite

Studies have shown that those who regularly practice meditation undergo brain morphometry; changes to brain structure, dimensions, arrangement of fibres, volume and density including measurements of grey and white matter (Fox et al., 2014 p. 52). Brain morphometry can be seen even after just brief periods of meditation on beginners (Ospina et al, 2008, p. 119), while long term meditators show significant alteration in various regions of the brain (Krygier et al., 2013, p. 306). Regular meditators have higher than average density in brain regions that are active during meditation, including right orbito-frontal cortex, right hippocampus, right anterior insula and inferior temporal gyrus. The cortices, insular and prefrontal cortices are thicker in the brain of those who practice regular meditation (Krygier et al., 2013, p. 306). Meditation has also been shown to increase the amount of alpha and theta waves waves in the brain (Sobolewski et al., 2011, p. 44)

Sensory cortices and Insular
The sensory cortices are regions of the brain which process physical sensation such as the sensation of touch and the feeling of pain. Research has shown that long term meditators have developed a higher pain tolerance. Mindfulness meditation can be used to decrease the sensation of pain, or put in another way, to increase the tolerance to pain (Fox et al., 2014 p. 62). The insular is linked to awareness of the self and bodily functions such as heart rate, breath and internal movements. This region has also been linked to emotional and cognitive awareness. Meditations effecting this region appeared to be those that focused on body awareness. Meditation of this type may assist with depression and anxiety as a component of these disorders consists of the perception of the body (Fox et al., 2014 p. 61-62).

Hippocampus
The hippocampus is responsible for learning to rationalizing emotions into context and triggering the production of an appropriate response. Decreased functioning of the hippocampus is associated with stress, anxiety and depression (Fox et al., 2014 p. 64). Neuroimaging shows that the hippocampus is active during meditation. Long term meditation can alter the structure of the hippocampus and enhance performance functioning for greater protection from the effects of stress. One theory suggests that benefits gained in the hippocampal area through meditation may be linked to the retrieval and reevaluation of past memories. Many meditation practices encourage the revisiting of past memories as an opportunity to see things in a new light, recognizing and becoming more aware of patterns of behavior and automatic actions. The hippocampus is also involved with the deep imaginative and creative flow of thoughts and ideas that occurs during meditation (Fox et al., 2014 p. 64)



Anterior cingulate cortex, mid cingulate cortex and amygdala


The anterior cingulate cortex and mid cingulate cortex are associated with concentrative solving of problems, self-control and behaviors which are adaptive during altering circumstances. It has also been shown to be active during the experience of pain, when an error is found, while regulating a conflict and during the processing of rewards. Studies indicate that meditation alters the brain structure in this area and may enhance the ability to make more conscious and attentive decisions, particularly when decisions are required to be made relatively quickly and many factors are required to be taken into account (Fox et al., 2014 p. 63). Studies showed that when utilising the reappraisal strategy for ER there was greater activity in the anterior cingulate cortex and decreased amygdala activity (Krygier et al., 2013, p. 306). The amygdala plays an essential role in labeling emotional stimuli (Ochsner, Bunge, Gross, Gabrieli, 2002, p. 1222). Disruption in connectivity to the mid cingulate cortex has been associated with a decrease in the experience of pain (Zeidan et al, 2012, p. 169). Those who scored higher on EA where also shown to have higher brain activity in their anterior cingulate cortex, a region of the brain vital to cognitively controlling emotions (Szcygiel et al, 2012, p. 434).

Orbitofrontal cortex
The orbitofrontal cortex (OFC) region in the brain is activated during mediation and reportedly associated with analysing stimuli and determining the correct motivational actions, ER, EA and specifically in lessening reactions and in reappraisal. Predictions have been made that long term meditation practice may increase the use of the OFC in its functions of determining appropriate behavior. Meditation reportedly improves the ability to act more adaptably and fluid, less rigid, comfortable with changing situations and better able to regulate negative emotions. It has been theorized that mediation may assist with depression, stress and anxiety through its structural alteration of this area (Fox et al., 2014 p. 63). A significant difference can be seen through the use of an EEG while monitoring reactions to visual stimuli in the activation of the frontal cortex in meditators which is not seen in non meditators (Sobolewski et al., 2011, p. 44).



Superior longitudinal fasciculus
The superior longitudinal fasciculus is associated with spatial awareness and the ability to perceive in 3D. This region of the brain undergoes structural changes through meditation, changes in this region are though to increase spatial body awareness (Fox et al., 2014 p. 64)



Corpus callosum
This area is the structural region acting as a connection highway for various other regions of the brain including frontal brain areas with visual cortices at the back of the brain. Differences are seen in the corpus callosum in long term practitioners of meditation. This may be due to an increase in grey matter which then requires thicker fibers for optimal connectivity (Fox et al., 2014 p. 64).



There are many other regions of the brain active during meditation and changed through meditation. One of the more interesting ones is the fusiform and inferior temporal gyri. This area in the brain is associated with blissful states, mystical experiences and enhanced feelings of well-being. Frequently reported as experienced by very progressed meditation practitioners, this region was previously known for it's activity during intense visual processing, perception and visual focus. Many meditation practices however, such as vipassana or Insight are done with open eyes while intense focus is put into staying present and aware. So it seems plausible that this area might be activated during these types of meditation (Fox et al., 2014 p. 63)



Discussion
Meditators are reportedly well known as "expert emotional regulators" (Perlman et al. as referenced in Teper, Inzlicht, 2013, para. 32) and "highly attuned to their emotions" (Teasdale et al., 2002; Niemiec et al., 2010 as referenced in Teper, Inzlicht, 2013, para. 32) and these abilities do not appear to discriminate between types of meditation practiced (Teper, Inzlicht, 2013, para. 36).

There is extensive research attributing to the positive affects of meditation on ER as well as other positive benefits (Teper, Inzlicht, 2013, para. 2). Regular practice of mindfulness and focused concentration over time seem to alter daily emotional processing functions in the brain (Sobolewski et al., 2011, p. 47). Studies find that meditation alters brain structure and improves emotional and cognitive functioning (Fox et al., 2014 p. 69). Changes to the brain structure during meditation may remain there after meditation training has ceased, or stay only while meditation is consistently practiced (Fox et al., 2014 p. 65).

The ability to comprehend another's emotional state is essential to functioning adequately in society. The ability to increase EA through meditation or therapy should improve the capacity for ER when experiencing more intense emotions (Szcygiel et al, 2012, p. 473). This could prove to be a useful tool to those experiencing difficulty in this area, at the very least, provides some hope that, with persistence, gains may be made in the ER realm.

Research shows that merely imagining an activity such as tensing the muscles into a fist is enough to trigger the body to increase blood-oxygen. As such, it seems plausible that simply placing your awareness on your body and internal processes is enough to regulate brain activity in this region and subsequently the structure in this region of the brain (Fox et al., 2014 p. 62).

While it is clear that meditation has an effect on emotional regulation and there is a vast range of research material covering meditation and emotional regulation, many studies have been critisised for being poorly structured and not presenting stronger conclusions (Sobolewski et al., 2011, p. 44).

Conclusion
Research on the effects of meditation on emotional regulation is a relatively new field of research which is rapidly expanding. Many research articles are able to draw conclusive answers from studies about what brain alterations are observed and what this indicates. Many other studies note that changes were seen without being able to determine what exactly this means. Continual research in this area will provide further knowledge and better understanding. There is a positive relationship between meditation and emotional regulation and this is worthwhile pursuing for the benefits gained, particularly in the area of reducing stress, anxiety and depression.