Mindscape Collective is now The Consciousness Library. Same library, new name. You may need to sign in again. About the change
Skip to content

Sara W. Lazar

Massachusetts General Hospital, Harvard University

47 papers in the library · 9,847 citations · publishing 2000-2026

Papers

How Does Mindfulness Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective

Perspectives on Psychological Science October 14, 2011 Britta K. Hölzel, Sara W. Lazar, Tim Gard et al. 2,997 citations

Mindfulness meditation, the nonjudgmental awareness of present-moment experiences, improves well-being and reduces psychiatric and stress-related symptoms, leading to its integration into psychotherapeutic interventions. Despite a surge in publications, few theoretical reviews synthesize the literature into a comprehensive framework. This article explores four components through which mindfulness exerts its effects: attention regulation, body awareness, emotion regulation (including reappraisal, exposure, extinction, and reconsolidation), and a change in perspective on the self. Empirical research, including self-reports and experimental data, supports these mechanisms. Neuroimaging studies show mindfulness practice is associated with neuroplastic changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network, and default mode network. The authors suggest these components work synergistically to enhance self-regulation, guiding future research and treatment development.

Meditation experience is associated with increased cortical thickness

Neuroreport November 7, 2005 Sara W. Lazar, Catherine E. Kerr, Rachel H. Wasserman et al. 1,707 citations

Long-term meditation practice is linked to structural changes in the brain. Magnetic resonance imaging of 20 experienced Insight meditation practitioners showed greater cortical thickness in regions involved in attention, interoception, and sensory processing, including the prefrontal cortex and right anterior insula, compared to matched controls. The difference in prefrontal thickness was most pronounced in older participants, suggesting meditation may counteract age-related cortical thinning. Thickness in two regions also correlated with meditation experience. These findings provide the first structural evidence that meditation practice can induce experience-dependent cortical plasticity.

Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation

Perspectives on Psychological Science October 10, 2017 Nicholas T. van Dam, Marieke K. van Vugt, David R. Vago et al. 1,500 citations

Mindfulness meditation has become widely used in therapy, corporate wellness, education, and the military, but the research backing it has faced criticism for poor methodology and misinformation. This article reviews the current state of mindfulness research, discussing difficulties in defining mindfulness, the proper scope of studies, and key methodological issues. The authors summarize what is known and unknown, offering a prescriptive agenda for contemplative science that focuses on assessment, training, possible adverse effects, and brain imaging. The goal is to inform scientists, media, and the public, minimize harm, curb poor research practices, and stop the spread of misinformation about mindfulness's benefits, costs, and future.

Contemplating Mindfulness at Work

Journal of Management November 19, 2015 Darren Good, Christopher Lyddy, Theresa M. Glomb et al. 1,007 citations

A growing body of evidence suggests mindfulness is closely tied to many aspects of workplace functioning, but this knowledge has not been systematically integrated. This review organizes the expanding mindfulness scholarship into a framework to guide management research. The framework shows how mindfulness affects attention, which then influences cognition, emotion, behavior, and physiology. These domains ultimately impact key workplace outcomes such as performance, relationships, and well-being. The evidence on mindfulness at work raises important questions and challenges key assumptions in management science, pointing toward an agenda for future research.

Functional brain mapping of the relaxation response and meditation

Neuroreport May 1, 2000 Sara W. Lazar, George Bush, Randy L. Gollub et al. 443 citations

Meditation, a conscious mental process that induces a set of integrated physiologic changes known as the relaxation response, activates specific brain regions. Using functional magnetic resonance imaging (fMRI), signal increases were observed in the dorsolateral prefrontal and parietal cortices, hippocampus/parahippocampus, temporal lobe, pregenual anterior cingulate cortex, striatum, and pre- and post-central gyri during meditation. Global fMRI signal decreases were also noted, likely secondary to accompanying cardiorespiratory changes. The findings suggest that meditation practice activates neural structures involved in attention and control of the autonomic nervous system.

Mindfulness starts with the body: somatosensory attention and top-down modulation of cortical alpha rhythms in mindfulness meditation

Frontiers in Human Neuroscience January 1, 2013 Catherine E. Kerr, Matthew D. Sacchet, Sara W. Lazar et al. 329 citations

Standardized mindfulness practices that focus attention on breath and body sensations may work by training the brain to better regulate alpha rhythms (7-14 Hz) in the primary somatosensory cortex. These alpha rhythms filter sensory information entering the neocortex. The framework suggests that in chronic pain, somatic attention in mindfulness reduces pain-focused attentional resources by altering alpha activity. In depression relapse prevention, somatic attention competes with rumination, as internal cognitive processes rely on alpha filtering. A computational model predicts enhanced top-down modulation of alpha through precise timing changes in thalamocortical inputs. The theory aligns with Buddhist teachings that mindfulness begins with mindfulness of the body, proposing that enhanced alpha regulation improves detection and regulation of mind-wandering.

Neural mechanisms of symptom improvements in generalized anxiety disorder following mindfulness training

NeuroImage Clinical January 1, 2013 Britta K. Hölzel, Elizabeth A Hoge, Douglas N. Greve et al. 285 citations

Mindfulness training alters brain activity in regions involved in emotion regulation among people with generalized anxiety disorder (GAD). In a preliminary study, 26 GAD patients were randomly assigned to either an 8-week Mindfulness-Based Stress Reduction (MBSR) program or a stress management education control. At baseline, GAD patients showed higher amygdala activation than healthy participants when viewing neutral faces, indicating heightened reactivity to ambiguous stimuli. After both interventions, amygdala activation to neutral faces decreased. MBSR, but not the control, led to greater increases in ventrolateral prefrontal cortex (VLPFC) activity and strengthened amygdala-prefrontal functional connectivity. These brain changes correlated with reductions in anxiety scores, suggesting clinical relevance. The shift from negative to positive amygdala-prefrontal coupling may represent a unique mechanism of mindfulness.

Pain Attenuation through Mindfulness is Associated with Decreased Cognitive Control and Increased Sensory Processing in the Brain

Cerebral Cortex December 15, 2011 Tim Gard, Britta K. Hölzel, Alexander T. Sack et al. 275 citations

Pain can be modulated by mindfulness, but the underlying brain mechanisms differ from those of other cognitive techniques. Mindfulness practitioners reduced pain unpleasantness by 22% and anticipatory anxiety by 29% during a mindful state, while controls did not. In the brain, this reduction was associated with decreased activation in the lateral prefrontal cortex and increased activation in the right posterior insula during stimulation, and increased rostral anterior cingulate cortex activation during pain anticipation. These findings indicate a unique mechanism of pain modulation involving increased sensory processing and decreased cognitive control, contrasting with established mechanisms.

Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression

Frontiers in Psychology June 30, 2016 Marasha De Jong, Sara W. Lazar, Kiran Hug et al. 200 citations

Chronic pain and depression are linked to reduced body awareness. Mindfulness-Based Cognitive Therapy (MBCT) increased certain aspects of body awareness—specifically self-regulation and not distracting from bodily sensations—more than treatment as usual in 31 patients with chronic pain and active depression. The improvement in depression severity was partly explained by the increased ability to not distract from bodily sensations. These results offer preliminary support for the idea that mindfulness interventions can enhance body awareness in this population and highlight its clinical importance.

The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis

Neuropsychology Review August 4, 2021 Tim Whitfield, Thorsten Barnhofer, Rebecca L. Acabchuk et al. 193 citations

Mindfulness-based programs (MBPs) show a small but significant benefit for cognitive performance, particularly for executive function and working memory, according to a meta-analysis of 56 randomized controlled trials involving 2,931 adults. The overall effect favoring MBPs over comparators was small (g = 0.15). Benefits were strongest for non-clinical samples and adults over 60, and when MBPs were compared to inactive controls rather than active ones. No significant effects were found for other cognitive domains. Most studies had unclear risk of bias, and some statistical results were unreliable. The findings partially support the idea that mindfulness practice can enhance certain cognitive abilities.

Mindfulness‐Based Cognitive Therapy for Nonremitted Patients with Bipolar Disorder

CNS Neuroscience & Therapeutics April 2, 2011 Thilo Deckersbach, Britta K. Hölzel, Lori Eisner et al. 130 citations

A mindfulness-based cognitive therapy (MBCT) program tailored for bipolar disorder was tested in 12 individuals. After 12 group sessions and at a 3-month follow-up, participants showed increased mindfulness, reduced residual depressive mood symptoms, fewer attentional difficulties, and improvements in emotion regulation, psychological well-being, positive affect, and psychosocial functioning. The findings suggest MBCT may help manage residual mood symptoms and improve overall functioning in people with bipolar disorder.

Change in Brainstem Gray Matter Concentration Following a Mindfulness-Based Intervention is Correlated with Improvement in Psychological Well-Being

Frontiers in Human Neuroscience January 1, 2014 Omar Singleton, Britta K. Hölzel, Mark Vangel et al. 116 citations

Participation in an 8-week mindfulness-based stress reduction (MBSR) course led to increases in psychological well-being (PWB) scores, which were positively correlated with increases in gray matter concentration in two bilateral clusters in the brainstem, including the pontine tegmentum, locus coeruleus, nucleus raphe pontis, and sensory trigeminal nucleus. These brain areas are sites of norepinephrine and serotonin synthesis and release, which modulate arousal and mood. No brain regions showed a negative correlation with PWB change. This preliminary finding suggests a neural basis for enhanced well-being through mindfulness training.

Fluid intelligence and brain functional organization in aging yoga and meditation practitioners

DOAJ (DOAJ: Directory of Open Access Journals) April 1, 2014 Tim Gard, Tim eGard, Maxime eTaquet et al. 104 citations

Fluid intelligence declines slower in middle-aged yoga and meditation practitioners than in matched controls. Resting state functional brain networks of practitioners are more integrated and resilient to damage. Mindfulness correlates positively with fluid intelligence, network resilience, and global network efficiency. The findings suggest that mindfulness may play a mechanistic role in preserving cognitive and brain function during aging.

Mindfulness-Based Cognitive Therapy for Bipolar Disorder

Journal of Psychiatric Practice November 1, 2011 Jonathan P. Stange, Lori Eisner, Britta K. Hölzel et al. 83 citations

People with bipolar disorder often experience cognitive difficulties such as problems with executive functioning, even when their mood is stable. In an open pilot trial of mindfulness-based cognitive therapy (MBCT), participants reported significant improvements in executive functioning, memory, and the ability to start and complete tasks, as measured by the Behavior Rating Inventory of Executive Function and the Frontal Systems Behavior Scale. These cognitive improvements were linked to increases in mindful, nonjudgmental awareness of thoughts and feelings, but not to reductions in depression. Gains tended to fade after treatment ended, though some improvements in executive functioning persisted for three months. MBCT may serve as an adjunct to medication for improving cognition in bipolar disorder.

From Self-Esteem to Selflessness: An Evidence (Gap) Map of Self-Related Processes as Mechanisms of Mindfulness-Based Interventions

Frontiers in Psychology November 22, 2021 Willoughby B. Britton, Gaelle Desbordes, Rebecca L. Acabchuk et al. 77 citations

Self-related processes (SRPs) such as rumination, self-compassion, self-efficacy, and self-esteem are theorized to be key mechanisms of mindfulness-based interventions (MBIs). This evidence map introduces a framework for categorizing SRPs and assesses how well mindfulness training engages these targets and whether engagement relates to improved outcomes. Rumination shows the strongest evidence as a mechanism for depression, with support for other health outcomes as well. Self-compassion consistently engages with mindfulness training but inconsistently links to better outcomes. Decentering and interoception are emerging potential mechanisms, though their construct validity remains under development. Few SRPs have been measured in MBIs, and more research with well-validated measures is needed.

Reduced interference in working memory following mindfulness training is associated with increases in hippocampal volume

Brain Imaging and Behavior March 17, 2018 Jonathan Greenberg, Victoria Romero, Seth Elkin-Frankston et al. 69 citations

Proactive interference—when old information disrupts learning new material—can be reduced by mindfulness training. In a randomized trial, 79 participants completed either a 4-week web-based mindfulness program or a creative writing control. The mindfulness group showed lower proactive interference error rates after training. No group differences in hippocampal volume emerged, but improvements in proactive interference were linked to volume increases in the left hippocampus. These findings suggest mindfulness training protects against proactive interference, with benefits tied to hippocampal structural changes, and may have implications for conditions like aging, depression, PTSD, and childhood adversity where working memory and hippocampal volume are compromised.

Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs

Psychosomatic Medicine April 11, 2018 Gunes Sevinc, Britta K. Hölzel, Javeria A. Hashmi et al. 65 citations

Two meditation-based stress reduction programs—Relaxation Response (RR) and Mindfulness-Based Stress Reduction (MBSR)—both reduced stress, with MBSR showing a larger effect (Cohen's d = 1.02) than RR (Cohen's d = 0.50). Both programs activated shared neural pathways between ventromedial prefrontal regions and supplementary motor areas. However, the RR bodyscan meditation, which emphasizes physical relaxation, showed stronger connectivity between the right inferior frontal gyrus (involved in inhibition and control) and supplementary motor areas. The MBSR program, which emphasizes mindful awareness without explicit relaxation, uniquely improved self-compassion and rumination and showed connectivity between the right anterior insula (sensory awareness and salience) and pregenual anterior cingulate during meditation. These distinct neural patterns align with each program's theoretical focus.

Effects of a Mindfulness-Based Intervention on Self-Compassion and Psychological Health Among Young Adults With a History of Childhood Maltreatment

Frontiers in Psychology October 23, 2019 Diane Joss, Alaptagin Khan, Sara W. Lazar et al. 63 citations

A mindfulness-based behavioral intervention reduced stress and anxiety and increased mindfulness and self-compassion in young adults with mild-to-moderate childhood maltreatment. The mindfulness group showed reduced stress and anxiety and increased mindfulness and self-compassion, while the waiting list control group showed no significant changes. Changes in mindfulness were linked to changes in self-compassion, which in turn were linked to reduced depression and anxiety. More intervention sessions attended were associated with greater reductions in stress, anxiety, and depression, suggesting a dose-dependent effect. The intervention may help improve self-compassion and psychological health in this population.

Greater Anteroposterior Default Mode Network Functional Connectivity in Long-Term Elderly Yoga Practitioners

Frontiers in Aging Neuroscience July 2, 2019 Danilo Forghieri Santaella, Joana Bisol Balardin, Rui F. Afonso et al. 37 citations

Long-term elderly Hatha Yoga practitioners show greater functional connectivity between the medial prefrontal cortex and the right angular gyrus, key nodes of the default mode network, compared to non-practitioners matched for age, education, and physical activity. This cross-sectional study of 20 women who practiced yoga at least twice weekly for eight or more years and 20 yoga-naïve controls found no group differences in cognitive screening, depression scores, or daily living activities. The enhanced anteroposterior connectivity within the default mode network may reflect a neural correlate of healthier cognitive aging associated with sustained yoga practice.

Compassionate hearts protect against wandering minds: Self-compassion moderates the effect of mind-wandering on depression.

Spirituality in Clinical Practice August 2, 2018 Jonathan Greenberg, Tanya Datta, Benjamin G. Shapero et al. 37 citations

Depression is linked to high levels of mind-wandering and low self-compassion. In a depressed sample, mind-wandering was associated with higher depressive symptoms only among those with low self-compassion. Self-compassion predicted improvement in depression. An eight-week Mindfulness Based Cognitive Therapy (MBCT) program increased self-compassion and reduced mind-wandering compared to a treatment-as-usual control group. Longitudinally, increases in mind-wandering were linked to increases in depressive symptoms only among those whose self-compassion decreased. Self-compassion can protect against the harmful effects of mind-wandering in depression, and MBCT effectively targets both protective and risk factors for depression.

Hippocampal circuits underlie improvements in self‐reported anxiety following mindfulness training

Brain and Behavior September 18, 2020 Gunes Sevinc, Jonathan Greenberg, Britta K. Hölzel et al. 24 citations

Mindfulness meditation training is linked to structural changes in the hippocampus, specifically the subiculum, which are associated with reduced connectivity between the hippocampus and lateral occipital regions during the retrieval of extinguished fear memories. This reduced connectivity correlates with decreases in self-reported anxiety after mindfulness training. The findings suggest that the subiculum plays a key role in regulating interactions with contextual cues during memory retrieval, and that mindfulness training may foster resilience by altering these brain circuits.

Mindfulness-based cognitive therapy for depressed individuals improves suppression of irrelevant mental-sets

European Archives of Psychiatry and Clinical Neuroscience November 9, 2016 Jonathan Greenberg, Benjamin G. Shapero, David Mischoulon et al. 17 citations

Depressed individuals often struggle to suppress irrelevant mental sets, a cognitive deficit linked to the disorder. Mindfulness-based cognitive therapy (MBCT) plus treatment-as-usual, compared to a wait-list plus treatment-as-usual control, led to significantly lower depression scores and greater improvements in the ability to suppress irrelevant mental sets. Improvements in mental-set suppression were associated with reductions in depression. This provides initial evidence that MBCT can enhance this cognitive function and that such enhancement relates to depressive symptom relief.

Childhood adversity severity modulates the associations between adaptive psychological changes and amygdala volumetric changes in response to behavioral interventions.

Journal of Affective Disorders Reports January 1, 2024 Diane Joss, Junjie Lu, Martin H. Teicher et al. 16 citations

Among young adult survivors of childhood adversity, an eight-week Mindfulness-Based Intervention (MBI) and a Stress Management Education (SME) program both led to increased mindfulness, reduced stress, and improved depression, anxiety, and somatization symptoms, with no significant difference between the two groups. Neither group showed greater changes in amygdala volume. Within the MBI group, the severity of childhood maltreatment mediated the link between mindfulness changes and right amygdala volume changes. Across both groups, childhood maltreatment moderated the effect of trait anxiety changes on left amygdala volume changes. The findings suggest that psychological-change-dependent amygdala volumetric changes are not unique to mindfulness training.

Temporal dynamics and long-term effects of a mindfulness-based intervention for young adults with adverse childhood experiences.

Mindfulness September 1, 2024 Diane Joss, Martin H. Teicher, Sara W. Lazar 11 citations

Mindfulness-based interventions (MBIs) produce unique therapeutic effects for young adults with adverse childhood experiences, with improvements in trait mindfulness driving reductions in perceived stress, somatization, and hostility. In a clinical trial, 21 participants completed an 8-week MBI and 19 completed a stress management education control. Weekly and follow-up assessments over 18 months showed that mindfulness increases began at the end of the 8-week program, and most symptom reductions lasted 12 months without refresher courses. Only the MBI group showed mindfulness gains predicting later symptom decreases. The findings suggest that at least 8 weeks of MBI and a refresher at 12 months may be needed for lasting benefit.

Do contemplative practices make us more moral?

Trends in Cognitive Sciences October 1, 2023 Kevin Berryman, Sara W. Lazar, Jakob Hohwy 11 citations

Mindfulness meditation has both positive and negative effects on moral functioning, distributed across multiple dimensions of moral cognition and behavior. A multifactor construct that assesses outcomes across several aspects of morality reveals that contemplative practices do not uniformly improve morality; instead, they produce a mix of beneficial and detrimental influences on different moral actions. The study provides an empirically rigorous investigation into the impact of mindfulness on morality, showing that the effects are complex and not captured by unidimensional measures.