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Living with Grace, Aging with Grace:
The Art & Science of Meditation
John A. Astin, Ph.D.
California Pacific Medical Center
San Francisco, CA
What lies behind us and what lies
before us are tiny matters compared to
what lies within us.
-Ralph Waldo Emerson-
A Brief History of Medicine
2000 B.C.
1000 A.D.
1850 A.D.
1940 A.D.
1975 A.D.
2000 A.D.
Eat this root
That root is heathen. Say this prayer
That prayer is superstition. Drink this potion.
That potion is snake oil. Take this pill.
That pill is ineffective. Take this antibiotic.
That antibiotic is artificial. Eat this root.
A merry heart doeth good like a medicine.
Proverbs 17:22
“The separation of psychology from
the premises of biology is purely
artificial because the human psyche
lives in indissoluble union with the
body”
– Carl Jung
What is Meditation?
Definitions of Meditation

Concentration Practices
 Systematic
training of attention by focusing on
particular objects (breath, sound, image),
designed to settle down/quiet the discursive
mind

Awareness Practices
 Shifting
attention from the contents of
consciousness or awareness to awareness itself
- becoming familiar with the “Observing Self.”
Transcendental Meditation - TM
A mental technique, in which one cultivates a
unique state of restful alertness. One uses an
object of concentration (mantra) but does so
effortlessly. “As the body becomes deeply
relaxed, the mind transcends all mental
activity to experience the simplest form of
awareness, Transcendental Consciousness,
where consciousness is open to itself.”
Mindfulness Meditation
The effort to intentionally pay attention,
non-judgmentally, to one’s presentmoment experience and sustain this
attention over time. The aim is to cultivate
a stable and non-reactive present moment
awareness.
Benson’s Relaxation Response
1. Quiet Environment (eliminate distractions)
2. Mental Device (to reduce mental
distractions)
3. Passive Attitude (to reduce tension and
striving for results)
4. Comfortable Position (to minimize physical
tension)
“Don’t just do something,
sit there.”
--Sylvia Boorstein
Scientific Studies
Physiological Effects
Physiological differences between Transcendental Meditation and
rest, American Psychologist 42: 87981, 1987
Over a 3-month interval, systolic and diastolic blood pressure dropped by 10.6
and 5.9 mm Hg, respectively, in the Transcendental Meditation group, and 4.0
and 2.1. mm Hg in the PMR group, with virtually no change in the usual care
group. Schneider RH, Stagers F, Alexander CN, et al. A randomized controlled
trial of stress reduction for hypertension in older African-Americans.
Hypertension. 1995;26:820-827
A study of 616 initially normotensive
Finnish men found that those with high
levels of baseline hopelessness (negative
expectancy about the future and one’s
goals) were 3 times more likely to become
hypertensive in the intervening 4 years
Everson et al. Hypertension 2000; 35: 561-7
4-year follow-up of a meditation-based
program for the self-regulation of chronic pain
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N = 225 chronic pain patients (mean of 8 years w/pain)
Majority reported moderate to great improvement in
pain status at all follow-up time points
Reductions in psychological symptomatology
maintained at follow-up
68% ascribed 50% or more of their improvement to
meditation; 43% ascribed 80-100% of their
improvement to meditation program
Source: Kabat-Zinn et al., Clinical Journal of Pain 1987; 2: 159-173
The effects of mindfulness
meditation on psoriasis
37 patients w/psoriasis randomized to usual care
(phototherapy or photochemotherapy) or usual
care plus guided mindfulness meditation and
imagery tapes
 Subjects in meditation group showed significantly
more rapid clearing (at halfway and clearing
points) of psoriatic lesions than controls

-- Kabat-Zinn et al. Psychosom Med 1998;60:625-632
Research by Davidson et al.
Randomized trial of healthy high tech employees
under stress
 Subjects participating in 8-week meditation
course evidenced significant changes in brain
electrical activity (increased activity in left
prefrontal cortex associated in previous research
with positive affect)
 Increased immune response to injected influenza
vaccine - these changes were correlated with
change in hemispheric dominance

''I really am an empiricist in every aspect of my life,'' said
Michael Slater, a molecular biologist at Promega. ''I doubt
dogma, and I test it. I do it at the laboratory bench, but also
in my personal life. So this appealed to me, because I could
feel the reduction in stress. I could tell I was less irritable. I
had more capacity to take on more stressors. My wife felt I
was easier to be around. So there were tangible impacts.
For an empiricist, that was enough.'' Granted, that's not
enough for many other people, especially the scientific
skeptics. But Slater made an offhand comment that struck
me as a highly convincing, though thoroughly unofficial,
form of peer review. ''My wife,'' Slater said quietly, ''is dying
for me to start meditating again.''
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Davidson and colleagues carried out a study of
long-term Buddhist monks
Subjects had practiced for 15-40 years and logged
15,000-50,000 hours of mental training
Practiced a lovingkindness meditation “unrestricted readiness & availability to help all
living beings” and were compared to 10 subjects
with no prior meditation experience
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Monks demonstrated significant differences both
before and during meditation practice
Greater presence of high amplitude, fast moving
gamma waves and greater brain wave synchrony
(better organized and coordinated) than controls
Longer years of meditation associated w/ greater
change in brain activity (dose-response indicating
causation)
FMRI revealed increased activation of left
prefrontal cortex area as in previous study
Psychological Effects
3-year follow-up of mindfulness-based stressreduction in the treatment of anxiety disorders
N = 22 patients with anxiety disorders
 20 showed significant improvement in anxiety and
depression post-intervention and at 3 months
 18/22 showed maintenance of gains at 3 years on
Beck/Hamilton scales, number and severity of panic
attacks, Mobility Inventory
 Of 8 patients receiving medication or psycho-therapy
prior to program, 5 had discontinued or sought at
reduced level at follow-up

Source: Miller et al., General Hospital Psychiatry 1995; 17: 192-200
Studies of meditation have demonstrated
Reductions in mood disturbance in diverse
patient populations (e.g., breast and
prostrate cancer)
 Increased sense of control, spiritual
experiences, self-esteem
 Improvements in sleep disturbances

Spiritual Effects
“Meditation, it is said, is a way to evoke the relaxation
response. Meditation, others say, is a way to train and
strengthen awareness; a method for centering and focusing
the self; a way to halt constant verbal thinking and relax the
bodymind; a technique for calming the central nervous
system; a way to relieve stress, bolster self-esteem, reduce
anxiety, and alleviate depression. All of those are true
enough; meditation has been clinically demonstrated to do
all of those things. But whatever else it does, and it does
many beneficial things, meditation is first and foremost a
search for the God within.”
- Ken Wilber
“When there are no fantasies or mental images
in the heart, the intellect is established in its true
nature, ready to contemplate whatever is full of
delight, spiritual and close to God.”
Saint Hesychios (Philokalia (Vol. 1)
p. 178, text 93)
Peace/Contentment
 Wisdom (seeing clearly)
 Feelings of joy
 Equanimity
 Compassion
 Connection w/ Life/Universe/God
 Gratitude

“Because of this program, I feel like I can help make a better world by
making myself more peaceful and compassionate and nonjudgmental. And
my illness seems like it is just a part of the process – not as depressing and
uncontrollable.”
“Meditation has overwhelmed me with compassion for myself and others.”
“In a strange way, I also feel a greater kinship with the rest of the world
than I used to.”
The concepts of non-judgment and patience (especially compassion), and
just being aware of feelings without reaction or being carried away by
them—these are elements which are obviously not valued by our culture. Is
it any wonder we are sick, discontent, and killing each other? This is what I
will carry with me from the study.”
Meditation as Metaphor
Let what comes, come.
Let what goes, go.
What remains?
- Ramana Maharshi
Praise & blame,
gain & loss,
pleasure & sorrow
come & go like the wind.
To be happy,
rest like a great tree
in the midst of them all.
- The Buddha
“Suffering happens between
the ears. Everything else is
just a situation.”
--Adyashanti
“I have suffered a great
many misfortunes, most of
which never happened.”
--Mark Twain
Sky of
Awareness
Objects appearing
Sky of
Awareness
Objects appearing
Sky of
Awareness
Objects
appearing
Unknown
Known
Beyond
Mind &
Thought
Thought
“We don't see things as they are, we
see them as we are.”
-Anais Nin
Listening
Listen to the sounds
of life trees blushing in the wind,
water kissing stone,
the ocean’s thunder
and the silent shore
that greets it.
These thoughts
that torment you,
they’re just
disembodied voices.
Listen to them
as you would the wind
or the water,
sounds of life
that never threatened
anyone.
“The most beautiful thing we can experience
is the mysterious. It is the source of all true art
and science.”
Albert Einstein
Mechanisms of Action
Relaxation Response (physiological counter
to the fight-or-flight mechanism)
 Self-Regulation (increasing information in
the system in the form of greater awareness
leads to increased capacity for selfregulation and balance)

The Body as Self-Regulating Organism
BRAIN
Hypothalamus
CRF
Pituitary Gland
Turns off
ACTH
ACTH
Adrenal Gland
Circulating
Cortisol
Cortisol
Environmental Information
job demands, others reactions
to you, social climate
Bodily Information
muscle tension, fatigue,
vitality
Self
Mental-Emotional
Information
anger, frustration, calm,
irritability, impatience
To meditate is to be aware of
what is going on.
--Thich Nhat Hahn
Sitting for a
long time
Awareness of
some physical
discomfort
Lack of awareness of physical
discomfort
Stretch, relax
muscles
Chronic physical
strain
Tension relieved
Low back problems
Greater Awareness
=
More Information
in the System
More Information
=
Greater Balance
in the System