Epistemic Spot Check: Full Catastrophe Living (Jon Kabat-Zinn)

Link post

Full Catas­tro­phe Liv­ing is a lit­tle weird, be­cause be­tween the first edi­tion and the sec­ond a lot of sci­ence came out test­ing the the­sis. For this blog post, I’m re­view­ing the new, sci­enced-up edi­tion of FCL. How­ever I have or­dered the older edi­tion of the book (thanks, Pa­treon sup­port­ers and half.com) and have dreams of re­view­ing that sep­a­rately, with an eye to­wards iden­ti­fy­ing what could have pre­dicted the ex­per­i­men­tal out­come. E.g. if the ex­per­i­men­tal out­come is pos­i­tive, was there some­thing spe­cial about the model that we could rec­og­nize in other self-help books be­fore rigor­ous sci­ence comes in?

I origi­nally planned on fact check­ing two chap­ters, the sci­en­tific in­tro­duc­tion and one of the ex­plana­tory chap­ters. Do­ing the in­tro was ex­haust­ing and demon­strated a con­sis­tent pat­tern of “ba­si­cally cor­rect, from a small sam­ple size, find­ing ex­ag­ger­ated”, so I skipped the sec­ond chap­ter of fact check­ing. I also skipped the lat­ter two thirds of the book.

Overview

You’ve prob­a­bly heard about mind­ful­ness, but just in case: mind­ful­ness is a med­i­ta­tion prac­tice that in­volves be­ing pre­sent and not hold­ing on to thoughts, origi­nally cre­ated within Bud­dhism. Mind­ful­ness Based Stress Re­duc­tion (MBSR) is a spe­cific class cre­ated by the au­thor of this book, Jon Ka­bat-Zinn. The class has since spread across the coun­try; he cites 720 pro­grams in the in­tro­duc­tion. Full Catas­tro­phe Liv­ing con­tains both a play­book for teach­ing the class to your­self, the sci­ence of why it works (I’m guess­ing this is new?), a sec­tion on stress, and fol­lowup in­for­ma­tion on how to in­te­grate med­i­ta­tion into your life.

Introduction

Claim: Hu­mans are hap­pier when they fo­cus on what they are do­ing than when they let their mind wan­der, which is 50% of the time.

Ac­cu­rately cited, large effect size, pos­si­ble con­found­ing effects. (PDF). The slope of the re­gres­sion be­tween mind wan­der­ing and mind not-wan­der­ing was 8.79 out of a 100 point scale, and the differ­ence be­tween un­pleas­ant mind wan­der­ing and any mind not-wan­der­ing task was ~30 points. Pleas­ant mind wan­der­ing was ex­actly as pleas­ant as fo­cus­ing on the task at hand. Fo­cus­ing ac­count­ing for 17.7% of the be­tween-per­son vari­a­tion in hap­piness, com­pared to 3.2% from choice of task.

Some caveats:

  • Peo­ple’s minds are more likely to wan­der when they’re do­ing some­thing un­pleas­ant, and when they are hav­ing trou­ble cop­ing with that un­pleas­ant­ness. The study could be iden­ti­fy­ing a symp­tom rather than a cause.

  • The study pop­u­la­tion was ex­tremely un­rep­re­sen­ta­tive, con­sist­ing of peo­ple who chose to down­load an iPhone app.

Claim: Loss of telomeres is as­so­ci­ated with stress and ag­ing; med­i­ta­tion length­ens telomeres by re­duc­ing stress (lo­ca­tion 404).

Re­search slightly more the­o­ret­i­cal than is rep­re­sented, but the­o­ret­i­cal case is strong. (Source). First, let’s talk about telomeres. Telomeres are caps on the ends of all of your chro­mo­somes. Be­cause of the way DNA is copied, they will shorten a bit on ev­ery di­vi­sion. There’s a spe­cial en­zyme to re-lengthen them (telomerase), but lead­ing thought right now is that stress in­hibits it. Short telomeres are as­so­ci­ated with the dis­eases of ag­ing (heart is­sues, type two di­a­betes) in­de­pen­dent of chronolog­i­cal age. This is hard to study be­cause telomere length is a func­tion of your en­tire life, not the last week, but is pretty es­tab­lished sci­ence at this point.

Mind­ful­ness re­duces stress, so it’s not im­plau­si­ble that it could lengthen telomeres and thus re­duce ag­ing. The au­thors also pre­sent some ev­i­dence that nega­tive mood re­duces the ac­tivity of telomerase. This is a very strong the­o­ret­i­cal case, but is not quite proven.

Claim: Hap­piness re­search Dan Gilbert claims med­i­ta­tion is one of the keys to hap­piness, up there with sleep and ex­er­cise (lo­ca­tion 461).

Con­firmed that Gilbert is a hap­piness re­searcher and said the quote cited, al­though I can’t find where he per­son­ally re­searched this.

Claim: “Re­searchers at Mas­sachusetts Gen­eral Hospi­tal and Har­vard Univer­sity have shown, us­ing fMRI brain scan­ning tech­nol­ogy, that eight weeks of MBSR train­ing leads to thick­en­ing of a num­ber of differ­ent re­gions of the brain as­so­ci­ated with learn­ing and mem­ory, emo­tion reg­u­la­tion, the sense of self, and per­spec­tive tak­ing. They also found that the amyg­dala, a re­gion deep in the brain that is re­spon­si­ble for ap­prais­ing and re­act­ing to per­ceived threats, was thin­ner af­ter MBSR, and that the de­gree of thin­ning was re­lated to the de­gree of im­prove­ment on a per­ceived stress scale.” (lo­ca­tion 502)

Ac­cu­rate cita­tion, but: small sam­ple size (16/​26), and for the first study the effect size was quite small (1%) for re­gions of a pri­ori in­ter­est, and the sec­ond had quite wide er­ror bands (source 1) (source 2). How­ever the book does re­fer to these find­ings as pre­limi­nary.

Claim: “They also show that func­tions vi­tal to our well-be­ing and qual­ity of life, such as per­spec­tive tak­ing, at­ten­tion reg­u­la­tion, learn­ing and mem­ory, emo­tion reg­u­la­tion, and threat ap­praisal, can be pos­i­tively in­fluenced by train­ing in MBSR.” (lo­ca­tion 508).

Mislead­ing. Th­ese are re­ally broad claims and no spe­cific study is cited. How­ever, source 2 above has the fol­low­ing quote: “The re­sults sug­gest that par­ti­ci­pa­tion in MBSR is as­so­ci­ated with changes in gray mat­ter con­cen­tra­tion in brain re­gions in­volved in learn­ing and mem­ory pro­cesses, emo­tion reg­u­la­tion, self-refer­en­tial pro­cess­ing, and per­spec­tive tak­ing.” This is a very care­fully phrased state­ment in­di­cat­ing that mind­ful­ness is in the right bal­l­park for af­fect­ing these things, but is not the same as demon­strat­ing ac­tual change.

Claim: “Re­searchers at the Univer­sity of Toronto, also us­ing fMRI, found that peo­ple who had com­pleted an MBSR pro­gram showed in­creases in neu­ronal ac­tivity in a brain net­work as­so­ci­ated with em­bod­ied pre­sent-mo­ment ex­pe­rience, and de­creases in an­other brain net­work as­so­ci­ated with the self as ex­pe­rienced across time. […] This study also showed that MBSR could un­link these two forms of self-refer­enc­ing, which usu­ally func­tion in tan­dem.” (lo­ca­tion 508).

Ac­cu­rate cita­tion, small sam­ple size (36) that they made par­tic­u­larly hard to find (source). I can’t de­ci­pher the true size of the effect.

Claim: Rel­a­tive to an­other health class, MBSR par­ti­ci­pants had smaller blisters in re­sponse to a lab pro­ce­dure, in­di­cat­ing lower in­flam­ma­tion (lo­ca­tion 529).

True, but only be­cause the other class *raised* in­flam­ma­tion (source). Also leaves out the fact that both groups had the same cor­ti­sol lev­els and self-re­ported stress. So this looks less like MBSR helped, and more like the con­trol pro­gram was ac­tively coun­ter­pro­duc­tive.

For the record, this is where I got frus­trated.

Claim: “peo­ple who were med­i­tat­ing while re­ceiv­ing ul­tra­vi­o­let light ther­apy for their pso­ri­a­sis healed at four times the rate of those re­ceiv­ing the light treat­ment by it­self with­out med­i­tat­ing.” (lo­ca­tion 534)

Ac­cu­rate cita­tion (of his own work), small sam­ple size (pdf).

Claim: “we found that the elec­tri­cal ac­tivity in cer­tain ar­eas of the brain known to be in­volved in the ex­pres­sion of emo­tions (within the pre­frontal cere­bral cor­tex) shifted in the MBSR par­ti­ci­pants in a di­rec­tion (right-sided to left-sided) that sug­gested that the med­i­ta­tors were han­dling emo­tions such as anx­iety and frus­tra­tion more effec­tively. […]

This study also found that when the peo­ple in the study in both groups were given a flu vac­cine at the end of the eight weeks of train­ing, the MBSR group mounted a sig­nifi­cantly stronger an­ti­body re­sponse in their im­mune sys­tem”

Ac­cu­rate cita­tion (of his own work), slightly mis­lead­ing, small sam­ple size. Once again, he’s strongly im­ply­ing a be­hav­ioral effect when the only ev­i­dence is that MBSR touches an area of the brain. On the other hand, the origi­nal pa­per gets into why they make that as­sump­tion, so ei­ther it’s cor­rect or we just learned some­thing cool about the brain.

Claim: MBSR re­duced loneli­ness and a par­tic­u­lar in­flam­ma­tory pro­tein among the el­derly (lo­ca­tion 551).

Not statis­ti­cally sig­nifi­cant. (source) More speci­fi­cally; the loneli­ness find­ing was sig­nifi­cant but un­in­ter­est­ing, since the treat­ment was “8 weeks with a reg­u­lar so­cial ac­tivity” and the con­trol was “not.” The in­flam­ma­tion find­ing had p = .075. There’s noth­ing magic about p < .05 and I don’t want to wor­ship it, but it’s not a strong re­sult.

I also re­searched MBSR in gen­eral, and found it to have a sur­pris­ingly large effect on de­pres­sion and anx­iety.

The Model

To the ex­tent Full Catas­tro­phe Liv­ing has a model, it’s been in­te­grated so fully into the cul­tural zeit­geist that I have a hard time ar­tic­u­lat­ing it. It could be sum­ma­rized as “do these prac­tices and some amount of good things from this list will hap­pen to you.” Which kills my hy­poth­e­sis that hav­ing a good model is nec­es­sary to get­ting good re­sults.

You Might Like This Book If…

I don’t know. I found it a slog and only read the first third, but the em­piri­cal ev­i­dence is very much on mind­ful­ness’s side and I don’t know what bet­ter thing to sug­gest.

Thanks to the in­ter­net for mak­ing it pos­si­ble for me to do these kinds of in­ves­ti­ga­tions.

Thanks to Pa­treon sup­port­ers for giv­ing me money.