Dr. Sara Lazar: How Mindfulness Changes Pain And Fear Responses

Speaker 1 · 0:00Welcome everyone. We're really grateful to have Dr. Sarah Lazar with us. Actually, on the recommendation of Margaret Cullen, who spoke with us about equanimity. Dr. Lazar is a neuroscientist who studies the impact of mindfulness meditation on the brain. She is an associate professor at Harvard Medical School and Mass General Hospital. She also serves on the board of directors for the Institute for Meditation and Psychotherapy. And her talk today will be on the neural correlates of equanimity in relation to pain and fear. So maybe we'll get answers to this question. Does mindfulness meditation protect the brain from pain and fear? But I'll let her take over. I'm really interested in hearing what she has to say. And so, Dr. Lazard, thank you again for being here.

Speaker 2 · 0:53Thank you for inviting me. I always love talking with teachers. I'm told that a lot of teachers start with science because it helps break down doubt and resistance. So hopefully some of these will be useful for conveying to your students. What I found, because I get this question a lot, it's like, you know, how much do you need to practice? What I find is that definitely

Speaker 2 · 1:10you need to practice in general to get benefits. But then during the day, when craziness happening really makes a difference. So we're going to talk about pain and fear and meditation in the brain. I find a lot of people get hung up on the non-judgmental. And I prefer to replace this with equanimity because we want to use discernment and we need to use judgment to understand what's going on, but pay attention with balance with non-reactivity. For me, that's more closer to my definition of mindfulness. So what is equanimity? It's important to make a distinction between equanimity and indifference. Because both of them are sort of non-reactivity. The way one of my teachers has defined it is that with equanimity, the heart is open. With indifference, the heart is closed. So if someone comes to you and starts telling you this sob story, are you just like, yeah, yeah, yeah, whatever? Or like, oh, tell me, I want to listen. And that's the difference. And so can you listen but just be open and non-reactive versus just like, yeah, okay, whatever. That's the key difference. Another thing, too, I often get there's mindfulness, there's meditation, there's mindfulness meditation. Are they the same? Are they different? No. Mindfulness is just being aware and paying attention in this particular way. And you can do it anytime, anywhere. But it's hard for to do that. And so we practice mindfulness meditation because mindfulness is a skill. And like any other skill, it can be trained. And so mindfulness meditation is a way to train the state of mindfulness. And so, as you know, it's open, relaxed, curious. We're focusing on the breath or body sensations. There you really can be anything. And the key thing is in the present moment, we're not lost, we're not spaced out, we're not in a trance. And again, this non-judging, equanimous

Speaker 2 · 2:45attitude. So we got mindfulness, you got mindfulness meditation, and then you got mindfulness-based stress reduction, which, as you likely know, is just this original eight-week program that you know introduced mindfulness in a secular way in a clinical setting. So many, many benefits. You got decreased stress, both self-reported stress and also cortisol and other things like that. But you also have reduced symptoms associated with depression, anxiety, pain, insomnia, many other conditions as well. I like to highlight these four just because these are so prevalent. It doesn't matter what a person has, if they got cancer or heart disease, anything under the sun, it's extremely likely they also have at least low levels of depression, anxiety, pain, or insomnia. They're just so prevalent because we know the whole mind-body connection. And so even if someone has, you know, cancer or heart disease, if we can help them with their stress and their depression and anxiety and whatnot, that will have secondary benefits on whatever else they may have. Plus, just for the rest of us who are everyday levels anxiety, depression, it really helps us. Importantly, there's more and more evidence suggesting that it's not just about getting rid of the bad stuff. It also helps promote quality of life, resilience, happiness. I started practicing yoga as a form of physical therapy. I was a runner and I developed injuries. And so I stopped running and just stretched. And I saw an ad for a vigorous yoga class, and I thought that'd be a great way

Speaker 2 · 4:05to just stretch. And after just a few weeks, it changed my life. I was like, oh my God. I was just seeing things differently. And so I knew something my brain had changed. That was what got me interested in doing this research. I was really interested in the actual structure of the brain. Could we actually see changes in the structure of the brain? And it's not uncommon after these eight-week programs for people to say, oh my God, this program changed my life. So the question was, could we see changes in the brain structure after just eight weeks? And the short answer is yes. People either went through MBSR or they were just scanned eight weeks apart. What we see is that there were several brain regions where there was more gray matter after training than before compared to the wait lists. Neurons kind of look like trees with lots of branches and lots of roots, and those take up space. When you have more gray matter, you can get more or fewer branches. And you can also send the branches in new directions. That's one way to get more gray matter. The gray matter is surrounded by all sorts of helper cells and blood vessels and whatnot. People used to think that the neurons were doing all the work and all the other stuff are just metabolic support. But there's more and more evidence that some of those cells are actually doing important things. And so the increased gray matter, we don't know if it's about the neurons themselves or if it's about these helper cells. But we do know is that changes in gray matter structure are associated with changes in activity and behavior. In this first study, we just looked at structure. So when you see something, you think, how is that relevant to me? This is the part of the brain that's trying to figure out, okay, how is this relevant to me? And you might think, hmm, those are things that are not supposed to get more in meditation. But with gray matter, sometimes more gray matter means more activity, sometimes more gray matter means less activity because there's inhibitory neurons and inhibitory processes. We think in this case, there's decreased activity in the same region where we're seeing increases in the gray matter. So we think that this might be some sort of inhibitory action happening. We also found changes in the supermarginal gyrus and the hippocampus. Supermarginal gyrus or SMG is about perspective taking. So seeing things from other people's point of view. Also, perspective, like, do I look at the outside and pay attention to what's outside? Or do I gain perspective on my inner world and pay attention to my inner world? And then the hippocampus is about learning and memory. And what's interesting is that these three regions spend a lot of time talking to each other. They're in a network called the default mode network. And the default mode network, as the name implies, is the network that's sort of on when you're kind of not doing anything particular. So when you're driving and you're stopped at a light and you're sort of waiting there, or you know, standing in line at the grocery store or just letting your mind wander, these are the regions that are most active. Oops, come back. We know that this is what gets turned down during meditation. And there's been a lot of research showing that this network gets turned down during meditation and it's also altered after eight weeks of practice. So this data is really consistent

Speaker 2 · 6:55with this, that we're really literally changing the structure of the brain in this network that's all about mind wandering and self-processes. So they're changing in eight weeks, but they're also doing really important stuff. And we'll talk about what they're doing in the rest of the talk. We also found decreases in the amygdala and increases in this part of the brain stem. The changes in the amygdala were related to decreases in stress, and the amygdala is all about fear and anxiety and stress. And so this was really important because up until this point, a lot of people said, well, people are going through this eight-week stress reduction program, and you know, it's been two months. Whatever was stressing them out before, just not stressing them out anymore. Or they're saying they're less stressed because they paid a lot of money or they like their teacher and they're just trying to please the teacher. But this data really strongly suggests that no, there's a neurobiological reason why they're feeling less stressed. Their amygdala is getting rewired and their brain is just not wired the same way anymore. This is the area where like serotonin, norepinephrine, and dopamine are produced, which are like the mood molecules. And serotonin is also important for like diet and arousal and depression. What we saw is that changes here correlated with well-being. What was interesting is it's only been eight weeks. And the tests we give asks questions like, how satisfied are you with your job? How satisfied are you with your family? How satisfied are you with your neighborhood, with your income? None of those things had changed over the course of the eight weeks. But yet people were saying that they were more satisfied with the conditions of their life after just eight weeks. And this also very, very clearly shows us that stress and well-being are not just the same thing. One is related to amygdala and the other is related to here in the brainstem. And that meditation is helping both, turning down the bad stuff, the stress and anxiety, but it's also turning up the life satisfaction.

Speaker 2 · 8:40All right, so now we're going to talk about pain. This is a study done by one of my students. And first, just a little bit about pain. How does pain work? Imagine that, say they burn their finger on the stove. The painful symptoms comes in, goes up their spinal cord, into their brainstem, it gets processed by this blue network. So the blue network is all about how you feel about it. This is all the sensory cortex. And so it evaluates okay, there's this burning sensation, or perhaps it's like if you cut your finger, maybe there's like some stabbing or tingling or the actual physical sensation you feel about it. But then there's also the emotional component to it. I don't like this. This hurts. Make it stop. In terms of pain regulation, there's a lot of different ways to control pain. And what's been shown is that they all work the same way in terms of neuroscience. With all of these, the front of the brain, which is the executive control part of the brain, literally shuts down this network. So the signal comes in and instead of coming up into the brain and getting processed, it literally just blocks it here. And so therefore the signal comes in and it doesn't go up. Literally, you don't feel the pain, or you feel the pain less because the signals are just being stopped right at the source. All of the known pain strategies work the same way. So the question was what about mindfulness? People have shown that mindfulness is good for pain regulation. Does it work the same way as everything else? So to do this, we put people in the scanner and during 40-second phase, we just randomly give them a very mild electric shock to the back of their hand a couple of times over 40 seconds. And then we ask them to rate both the physical sensations, how much the burning, tingling sensation was, and then also the affected component, like how much did you not like it? How unpleasant was it? And we know that those two are very dissociable. I can give the exact same pain stimulus to 100 people and ask them to read it on a scale of one to 10. Some people will give it like a four or five, others will give it a 10. And it just has to do with past history, you know, and how you've learned to deal with pain and how much pain you've had to deal with in the past. And so what happened? We put them in the scanner, and what we see is that in the mindfulness practitioners, in the normal state, it's on. But then when they start meditating, it gets turned off. But in the controls, we see the opposite, that it's not really on. But then when they start experiencing the pain, it gets turned up. And this is the part of the brain that's like, I don't like it, make it stop. And it gets turned on by all other forms of pain control. For the controls, it's looking like all other forms of pain control. But for the mindfulness practitioners, it's looking the opposite. Similarly, this is the sensory network. So this is the one that's actually evaluating what am I feeling right now? What am I actually sensing? The burning, throbbings, tingling, stabbing. And here, what we see is the mindfulness practitioners turn this up and the controls turn this off. The controls were told to be mindful five minutes before they went into the scanner, told what mindfulness is. They never really practiced it before. And so during the meditation phase, they're just told to, okay, be mindful of the pain. So for the controls, it's looking like all the others, and that, but they don't really know what they're doing. So they're just turning off the pain. But for the mindfulness practitioners, they're doing the opposite. They're turning off the control and they're turning up the actual sensory experience. So what does this mean? So at first, this is like a huge head scratcher. Like, what is going on? What does this mean? But then we thought about the definition of mindfulness. Mindfulness is paying attention to the present moment in an open, non-reactive, non-judgmental way. So what are they doing? They're paying attention to it. Compared to their normal state, they're paying more attention to the sensory experience. And they've turned off the I don't like it, make it stop, judgmental part of the brain, the non-equanimous part of the brain. This is equanimity. They're not blocking it, they're not trying to defend against it, they're not trying to stop it in any way. And in fact, they're feeling it more and they're not trying to stop it. But yet then when we ask them to rate the pain, what we see is that in terms of the intensity, like, okay, how much was it stabbing, burning, throbbing, that didn't change. But in terms of the unpleasantness, huge drop. They're experiencing it more. They're open to it, they're really feeling it, but they're saying, yeah, it's not that bad. This is equanimity. We can see it in their behavior, in their ratings, and we see it in the brain that literally they're not trying to stop things happening from as they are. They're allowing things to be as they are and experiencing it openly. That's equanimity. Okay. Life is painful, suffering is optional. We cannot stop life from doing what life's gonna do. It doesn't matter. We're all gonna run into pain, emotional pain, physical pain at some point in our life. We cannot stop that. But we can change our response to it. And that's what we just saw in that last experiment, that they

Speaker 2 · 13:20could not stop. They were gonna get that pain no matter what, and they let it happen. Now we're gonna talk about fear of pain. And this is important clinically because a lot of chronic pain patients will say, Well, I didn't go do that because I was afraid I was gonna hurt more. And emotionally we tend to do that. Like I don't want to go there because I know it's gonna hurt emotionally. So fear controls our lives in many ways that we're not really aware of or think about, really. Gonna show you a couple of different experiments we did. It was really one experiment, but lots of different analyses. The study design was this. We put people through a two-day fear conditioning protocol, and I'm gonna give you all sorts of details about that. They were then randomized to either MBSR or to an eight-week exercise program. And then they went through the fear conditioning protocol again. All subjects were told that there was no control group and that both interventions were beneficial. And this is true. It's well known that exercise is really good for reducing stress. And so we weren't trying to say, is MBSR better than exercise for stress? Because that was not our primary outcome. We were cared about fear, fear of pain. That was our primary outcome measure. And also the question was also, are they doing it differently? Because if exercise and mindfulness

Speaker 2 · 14:30are the same in terms of how they work, then why should I meditate? You know, I might as well exercise it because then I get not only the stress benefits of meditation, but then I also get all the benefits of exercise. So why should I choose meditation and over exercise? That was the question. Could we find some differences of mechanisms andor any benefits to the meditation compared to exercise? And the exercise group, they also got information about diet, sleep hygiene, positive attitude, and humor. And it was structured very similar to MBSR in terms of class hours and homework. Both groups were told to practice 40 minutes per day at home. So the exercise group, either they got 40 minutes of exercise, or we also gave them various readings about stress. So they either listened to the audiobook or they exercised every day. And so, in terms of stress, no difference. From pre to post, MBSR and SME is stress management education. They were identical, absolutely no difference. But two of our other questionnaires, there were differences. So one is difficulty with emotion regulation, and the other one is anxiety. And we showed that only MBSR improved these two measures. Exercise had no impact on either of them. We also found that the hours of home practice predicted changes in both stress and the difficulty with emotion regulation. So the more people practice, the more they benefited. And this is important because everyone always asks, well, how much do I need to practice? And the simple answer is the more you practice, the more benefit you're gonna get, at least for stress. There are some studies that have not found correlations with amount of practice. Don't know what's going on with that, but at least some of our outcome measures, it's really clear, there's a very nice correlation, in particular with stress. You know, the more

Speaker 2 · 16:05you practice, the more you're gonna benefit. All right, fear conditioning. What are we doing? You all know about Pavlov's dogs. Normally, when you ring a bell, dogs do not respond to a bell. But if every time you feed a dog, you ring a bell, they learn that the bell means I'm gonna get fed. And so they start salivating when they hear the bell. What happens is that even if you stop doing it, at least for a little while, every time you ring the bell, they're going to salivate, even if you don't feed them, or they'll they'll ring the bell even if they don't see the food yet. This is called conditioning. And so we're gonna do the exact same thing, but instead of bells, we're gonna use lights. And instead of food, we're gonna again use that very mild electric shock. So again, they're in the scanner, they're getting the mild electric shock. But this time, instead of just receiving the shocks, right before the shock, they see different colored lights and they learn that some colors mean they're about to be shocked versus other colors mean I'm not about to be shocked and I'm safe. Question is, how do they respond to the lights? Not to the being shocked, but to the seeing the lights that's gonna tell them I'm about to be shocked versus I'm safe. And very importantly, no information whatsoever was given to them about what to do in the scanner, other than look at the lights and figure out the pattern of what's gonna happen. So they were not told to be mindful in the scanner. It's a little bit of a complicated protocol, and I walk you through it bit by bit. So the first day, what they see is they see three different colors. And for two of the colors, in this case red and yellow, they get shocked. But one color, blue, they don't get shocked and they're safe. And everyone gets a different pattern. So some people, red is safe and yellow and blue means I'm getting shocked, and some with yellow. And color doesn't matter. Blue means I'm safe, red and yellow mean I'm shocked. So what happened? First, looking just at their skin conductance, which is about a measure of tension and apprehension, they see that red light and they know they're about to be shocked. At baseline, at pre, both the controls and then MVSR group, compared to when they saw the blue light and they knew they were gonna be safe, they had a big reaction saying, Oh my God, I'm about to be shocked. And you see that at the baseline, they're exactly the same. At post, after the eight weeks, what you see is that that's gone in the controls, but it's still there in the meditators. And at first, again, this is a bit of a head scratcher. We're like, huh, what's going on here? This is a metric of how much they're like saying, oh no, I'm not gonna feel it. They're turning on their front of the brain, shutting down, so they just don't feel it. And so they don't feel it. And so you don't respond to it because you're not feeling it. Versus the mindfulness group, after just eight weeks of practice, they're able to switch into being more equanimous and saying, okay, I'm about to be shocked. I'm not gonna shut down. I'm gonna remain open and allow myself to be shocked. Also consistent with this, what we found is that this was related to stress. So the more pre and post look the same, the more stress reduction people reported. And the more they look different, the less stress reduction people reported. So again, it suggests that if they're practicing, if they're benefiting, if they're really getting it, they look like this versus that they're not practicing and they're not reducing their stress, they look like this. We also found that there are changes in the connections of the amygdala to the front of the brain. And this connection is well known to play a big role in anxiety disorders. And we saw a change in the mindfulness group. And again, the change correlated with this. So the more the brain changed, the more they look like this, and the less the brain changed, the more they look like this. After eight weeks, you're more equanimous. And the changes in the white matter were important for this learning not to fear pain. All right, now we're gonna talk about extinction.

Speaker 2 · 19:45We know that mindfulness is good for reducing anxiety, general anxiety, social anxiety, phobias, PTSD. And there's something called exposure therapy. The way exposure therapy works is you expose the person to whatever it is that causes them fear and anxiety until basically they habituate and they just don't respond anymore. And we know that exposure therapy only works if the person is actually open and actually experiences the stimuli. So, say you have someone with a spider phobia, if they just can't even look at the picture of the spider and they're like, oh, oh no, go away. Exposure therapy doesn't work. Like you actually have to be open and let yourself feel it and really experience it in order for exposure therapy to work. And since we know mindfulness is all about being open and unreactive, we thought that this should be a good reason uh why it might work. The second part of this is extinction. So initially they see the red and the yellow lights, they get shocked, blue means I'm safe. Then immediately, when this stops, they get another scan, they see the red light and the blue light, but they don't get shocked to either one. So first they learn that red light means I'm gonna get shocked, then they learn red light means I'm safe. No change for blue. So what happens during extinction? Controls, there's no change. In the exercise group, there's no change. But in the mindfulness group, we get a big increase in something called the salience network. And as the name implies, salience network is how important is this to me? So they're getting a bigger response. So they see the lights and they're paying more attention to those lights. Because there's different attention networks in the brain. One of them is more external one. This is more an internal one. So it's paying attention to what's going on inside. The salience network is okay, not so much what's outside, but how is this important to my body and to my being? And what we're seeing is that it's this network, which is the insula and the caudate and the DLPFC, that these are regions that are like, okay, what's going on inside of me? Like, is this a threat to my internal system? We also see there's a big difference in the hippocampus. And I mentioned at the beginning that this is one of the regions that is changing in just eight weeks in terms of brain structure. And the hippocampus is all about learning in memory. And again, no change really in the exercise control group, but a big change in the mindfulness group. So it suggests that their hippocampus is more active, so they're better able to remember this. And this is important because you have to remember if the exposure therapy is going to work, you have to remember. Remember that, okay, I'm not gonna get shocked when I see that red light. And we see that the gray matter changes. So the more the gray matter changed, the bigger the changes in the brain activities. What was really cool was this finding. Who is the amygdala and hippocampus talking to? This yellow blob corresponds to where in the brain the hand is encoded. You may have seen something called the homunculus, right? So the whole body is encoded in this little strip of brain here. The face is down here, and then the hands and the arms, and then on the backside of it is the legs. This is they're in the scanner, they're not getting shocked, they're just looking at the lights. The mindfulness group, though, is paying attention to their hand. This is visual cortex, and it's an area that's more involved in vigilance. So the controls are paying attention to the visual cortex versus the meditators are paying attention to what's actually happening in my body. And that's during extinction. The question is, well, does it make a difference? For exposure therapy to work, it's fine if you're fine with a spider in the therapist's office. But then when you get home, do you freak out when you see a spider again? Right. And so that's where the hippocampus is plays an important role. In the therapist office, you learn that, okay, spiders are okay. And then you remember it. So then when you go home, I'm okay with the spiders at home. And we know that people with anxiety disorders, they don't learn, or it's much harder for them to learn. They get to the exposure therapy and it's just not as effective. And it's partly because they have smaller hippocampi. How do we test this? Day one, they learn red and yellow meaning I'm gonna get shocked. Then they learn that red light means I'm safe. They learn nothing new about the yellow light. We bring them in the next day and we show them all three lights, but we don't shock them. And so then the question is how do they respond to the red light? If extinction has been successful and been remembered, then when they see the red light, the response to the red light and the response to the blue light should be the same because they've learned that red light means I'm safe. However, if they've forgotten, if extinction has not worked and or if they've forgotten, then the response to the red light and the yellow light will be the same because yellow light still means I'm gonna get shocked as far as they're concerned. So that was the question. Does red light look like yellow or like blue? And the short answer is mindfulness improved their ability to remember red light means I'm safe. So in the control group, there was no change. They did not gain at all in this task. They responded the same way. Versus the meditation group, there was a significant improvement in their ability to remember that red light means I'm safe, and the group difference was significant. So here it is, day two. They're not getting shocked. They're in the scanner, they're looking at the lights, they're not actually getting shocked, but again, the mindfulness group is paying attention to their hand. And again, the controls

Speaker 2 · 24:45are paying attention to the lights. And this is an area that's known to be involved in anxiety. So the activity during this task is related to people's anxiety levels. And what we saw was that the change in anxiety correlated with changes in this. So for the mindfulness group, the more they turn this off, the better their anxiety improved. Similarly, this is the supermarginal gyrus. This is the one of the three regions I showed you at the beginning that gets bigger with practice and it's involved in paying attention to the inside world or the outside world and perspective taking. And again, we see that much bigger change in the mindfulness group compared to the exercise group. Also, it correlates with practice time. So the more people practice, the more this activated. So putting this all together, what it suggests is that for the mindfulness group, they're turning off the anxiety, oh my God, what light is happening and paying attention to the outside world and trying to figure that out. And instead, they're paying attention to what's actually happening in my body right now. So I'm seeing these lights, what's actually happening? And so I'm using my supermergental gyros to decide, okay, rather than paying attention out there, I'm gonna look inside. And so the conclusion for this part of the top is that mindfulness is more effective than exercise for fear and anxiety. They're both good for stress. When it comes to fear and anxiety, meditation is better. And it's mindful awareness of the body, which is so key. Yeah, I remember when I first started practicing, it's like, why are we paying attention to the breath and the body scan? And often people think, okay, well, you know, it's just you have to pay attention to something, but it's actually more than that because there's a forms of meditation where you look at the complex figure or flickering candle or you do a mantra or something. And those are all good, but this suggests that mindfulness, there's something extra you get from that body scan that it's not just you're paying attention to something, that you're getting more in tune with your body and you're paying more attention to your body, and that when you encounter life's difficulties, that makes a difference. That you're not just okay, I gotta relax now. It's like your mind automatically goes into, okay, what's going on in my body right now? What do I pay attention to? What's important for my physical self? And it's also showing us that we're shifting again from thinking and defending against threat to just experiencing life openly with equanimity. And so meditation is not evasion, it is serene encounter with reality. One of my favorite quotes. So we know all forms of exercise are generally good for reducing stress, building muscle, building cardiovascular fitness and whatnot. But we also know that there are subtle differences. So, like weight training is particularly good for joints and those sorts of things. There's subtle differences. And so, probably all forms of meditation are going to be good generally for reducing stress, but there has been a little bit of comparing meditation A to meditation B. And we know that they are different in the brain. And so there probably are going to be some subtle differences.

Speaker 2 · 27:30And so, again, my guess is if you were someone who just did flicker and candle, that probably you would not see these changes that we saw. Because again, it was really clear that it had to do with paying attention to the body. So if you're not habitually paying attention to your body, it's imagine like yoga would be something, or Tai Chi would probably give similar results, but flicker and candle and mantra might not. All right. So we're talking about doing a body scan. So let's do a body scan. So, how can we do that with meditation practice? How can we go from thinking, thinking, thinking to slow down and meditate? One way to be an off-ramp is to start with attention really wide and to look around the room. And one of my teachers says that looking at windows is particularly good and particularly helpful because it helps calm the nervous system and just get a really wide perspective. So just getting a sense of, okay, what if I feel like right now? Like how am I feeling right now and how's my mind right now? And then as I look out the window, just noticing, am I starting to calm down a little bit? Am I starting to settle in a little bit as I look out the window and look around the room? So just being mindful of, okay, how do I feel right now, both in my body and in my mind. And then bringing attention in to about an arm's width around you, like to your personal space bubble. What does that feel like?

Speaker 3 · 28:44And then bringing to just a few inches around the body. Your very, very, very personal space bubble. And a sense of the whole body head to toe.

Speaker 2 · 28:57And now bringing attention inside the body. And getting a sense of the whole body inside head to toe. What does that inner space feel like? And so now as we start the body scan, so again, checking out the mind and the body. How's the mind doing right now? We're gonna imagine a little spotlight about the size of a quarter, and we're just going to keep our attention in that spotlight. Starting at the top of the head. And just sweeping back and forth across the scalp, side to side, front to back. And just noticing any sensations you happen to notice.

Speaker 3 · 29:41Like there's nothing you have to feel, nothing you have to notice, but just training your attention to pay attention to

Speaker 3 · 29:50sensory experience. And can you move the spotlight whatever speed feels comfortable for you?

Speaker 2 · 29:58And can you get a sense both of the surface of your skin and also the underside? The whole thickness of the skin and what's right below it.

Speaker 4 · 30:11Side to side, moving front to back.

Speaker 2 · 30:16And now we're going to go across the forehead. Again, sweeping side to side, top to bottom. And if you encounter an area with tension, just pause and see if you can invite that area to relax a bit. Around the eyes and the bridge of the nose. The cheeks and the jaw. Just inviting the jaw to hang loose. Check in with your tongue. Is your tongue jammed up against the back of your teeth? If it is, can you invite it to just float in the bottom of your mouth?

Speaker 4 · 31:01Moving down into the neck and shoulders. Front and back, both sides. Inside and out. Inviting the shoulders to let go just a little bit. Moving down to the arms, the elbows and the forearms into the hands.

Speaker 2 · 31:22And just noticing what are you touching?

Speaker 3 · 31:26What are the hands touching? What's the actual felt sensation? Pressure, temperature, perhaps some tingling. Sensation you can't quite describe. Okay, nothing you have to feel. You're just training your attention to tune in to these sensations. Moving now into the rib cage. Front and back, side to side, inside and outside. How do you know you're breathing?

Speaker 2 · 32:02It's the actual felt sensation of the rib cage expanding and contracting as you breathe.

Speaker 4 · 32:10Moving down into the belly and diaphragm. Letting the belly hang loose.

Speaker 3 · 32:17Down into the legs, the knees, the shins. Into the soles of the feet. And again, noticing pressure, temperature, tingling. How'd you know your feet are touching something? So check in again, whole body, head to toe. Check in with the mind. How are you feeling right now? How is the mind right now? And then we'll come out the same way we came in. So expand your attention to just a few inches around your body. How does that feel now? And then tear your personal space bubble. And then out into the room.

Speaker 4 · 33:09And then out into infinity in space. Yeah, give a little shake, a little stretch. Ah, a deep breath. Yeah.

Speaker 3 · 33:25I needed that.