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David R. Vago

Brigham and Women's Hospital, Harvard University

33 papers in the library · 8,183 citations · publishing 2011-2026

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.

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.

Self-awareness, self-regulation, and self-transcendence (S-ART): a framework for understanding the neurobiological mechanisms of mindfulness

Frontiers in Human Neuroscience January 1, 2012 David R. Vago, David A. Silbersweig 1,324 citations

Mindfulness—whether as a state, trait, process, meditation type, or intervention—benefits a range of psychological disorders and reduces stress. However, how it works and how it is defined remain unclear. This paper presents an integrative theoretical framework and neurobiological model called S-ART (self-awareness, self-regulation, self-transcendence). It explains that systematic mental training develops meta-awareness, behavioral self-modulation, and prosocial characteristics that transcend self-focused needs. The model proposes that meditation modulates self-specifying and narrative self-networks via a fronto-parietal control network, supported by processes like attention regulation, emotion regulation, and decentering. The framework aims to guide future research in contemplative sciences and treatments for psychological disorders.

The Varieties of Self-Transcendent Experience

Review of General Psychology May 1, 2017 David Bryce Yaden, Jonathan Haidt, Ralph W. Hood et al. 682 citations

Self-loss is often linked to mental illness, but this review proposes that temporary states of reduced self-focus and heightened connectedness—called self-transcendent experiences (STEs)—may also promote mental health. The authors identify common psychological constructs with a self-transcendent aspect, such as mindfulness, flow, peak experiences, mystical-type experiences, and positive emotions like love and awe. Drawing on literature from social psychology, clinical psychology, and affective neuroscience, they propose psychological and neurobiological mechanisms that might underlie STEs' effects. The review concludes with suggestions for future empirical research to further explore these experiences.

Contemplative Practices and Mental Training: Prospects for American Education

Child Development Perspectives April 23, 2012 Richard J. Davidson, John D. Dunne, Jacquelynne S Eccles et al. 320 citations

A set of mental skills and socio-emotional dispositions—including self-regulation of emotion and attention, self-representations, and prosocial traits like empathy and compassion—are central to 21st-century education. These qualities can be strengthened through systematic contemplative practice, which induces plastic changes in brain function and structure, supporting prosocial behavior and academic success in young people. The authors call for focused programmatic research to determine which forms and frequencies of practice are most efficacious for which children and adolescents, and to document the neural changes induced.

Mindfulness meditation–based pain relief: a mechanistic account

Annals of the New York Academy of Sciences June 1, 2016 Fadel Zeidan, David R. Vago 304 citations

Treating chronic pain is challenging and costly because pain involves interacting sensory, cognitive, and affective factors. The opioid epidemic, driven by widespread opioid use for pain, underscores the need for fast-acting nonpharmacological alternatives. Mindfulness meditation significantly reduces pain in experimental and clinical settings through multiple, unique mechanisms, offering a narcotic-free, self-facilitated option for chronic pain patients.

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.

The brain on silent: mind wandering, mindful awareness, and states of mental tranquility

Annals of the New York Academy of Sciences June 1, 2016 David R. Vago, Fadel Zeidan 165 citations

Mind wandering and mindfulness are often seen as opposite mental states, with mind wandering linked to negative self-reflection and task disruption, and mindfulness linked to present-focused awareness and reduced stress. However, this article argues that the relationship is more nuanced, involving a skillful toggling between conceptual and nonconceptual processes to meet situational demands. The authors present a theoretical neurocognitive framework of the restful mind, drawing on literature about intrinsic network activity, meditation, and nonduality, to clarify adaptive contributions of both states. A neurophenomenological approach is proposed for probing concentration and nonconceptual awareness to better understand the resting state.

Future directions in meditation research: Recommendations for expanding the field of contemplative science

PLoS One November 7, 2018 Cassandra Vieten, Helané Wahbeh, B Rael Cahn et al. 124 citations

A survey of 1120 meditators found that most report having had anomalous and extraordinary experiences during meditation, such as mystical, transpersonal, or difficult phenomena. While meditation research has largely focused on clinical effectiveness and neural correlates, these less-studied experiences may be crucial for psychological and spiritual development, act as mediators of meditation's benefits, or be important outcomes themselves. A task force of researchers and teachers developed recommendations to expand research into these areas, which represent largely uncharted scientific terrain suitable for rigorous investigation.

Meta-analytic evidence that mindfulness training alters resting state default mode network connectivity

Scientific Reports July 18, 2022 Hadley Rahrig, David R. Vago, Matthew A. Passarelli et al. 83 citations

A meta-analysis of twelve studies (226 mindfulness participants, 204 controls) found that mindfulness training increased resting-state functional connectivity between the left middle cingulate cortex (part of the salience network) and the posterior cingulate cortex (a hub of the default mode network), compared to control conditions. This effect, though small (Hedge's g = 0.234), was statistically significant and showed low heterogeneity across studies. The result supports the idea that mindfulness training enhances communication between brain networks involved in flexible, internally-oriented attentional control. No evidence of publication bias was detected.

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.

The (In)flexible self: Psychopathology, mindfulness, and neuroscience.

International journal of clinical and health psychology : IJCHP January 1, 2023 Fabio Giommi, Prisca R. Bauer, Aviva Berkovich-Ohana et al. 70 citations

Rigidity, or inflexibility, is a core feature of transdiagnostic processes underlying many mental health disorders. The pattern theory of self (PTS) defines the self as a dynamic, nonlinear pattern of multiple interacting processes. Mindfulness-Based Interventions (MBIs) can reduce rigid, habitual self-patterns, thereby improving mental health. MBIs alter psychological and behavioral aspects of the self-pattern and can shift the entire self-pattern as a gestalt. Neuroscientific evidence shows that the phenomenology of the self is reflected in cortical networks, and meditation alters these networks. Combining PTS and neuroscientific findings may deepen understanding of psychopathology and improve diagnosis and treatment.

Experiential self-referential and selfless processing in mindfulness and mental health: Conceptual model and implicit measurement methodology.

Psychological Assessment April 14, 2016 Yuval Hadash, Reut Plonsker, David R. Vago et al. 69 citations

The cognitive association of present-moment subjective experience with the self, termed Experiential Self-Referential Processing (ESRP), may underlie various forms of maladaptation, while mindfulness may promote mental health by fostering Experiential Selfless Processing (ESLP), which involves processing experience without self-referentiality. A new implicit behavioral measure, the Single Experience & Self Implicit Association Test (SES-IAT), was developed to assess ESRP and ESLP of fear. In a randomized experiment with 138 adults, preliminary evidence suggested the SES-IAT measures ESLP and two forms of ESRP: identification with fear and negative self-referential evaluation of fear. ESRP and ESLP were associated with meta-awareness and key psychobehavioral processes underlying adaptation and maladaptation.

Mapping modalities of self‐awareness in mindfulness practice: a potential mechanism for clarifying habits of mind

Annals of the New York Academy of Sciences October 1, 2013 David R. Vago 68 citations

Mindfulness-based practices in psychotherapy are examined through both Buddhist and neurocognitive lenses. The article describes how noting and labeling techniques in open monitoring meditation can access multiple modalities of awareness, potentially transforming maladaptive mental habits and perceptual biases. It proposes that these practices improve cognitive efficiency, facilitate integration, and provide flexibility between self-processing systems. A model is offered for how noting and labeling may influence low- and high-level neural processing at different stages, with hypotheses about how practice extent affects each level. The work also discusses implications for subjective experience and self-processing in relation to habits of mind, behavior, and one's relation to the external world.

Mapping meditative states and stages with electrophysiology: concepts, classifications, and methods.

Current Opinion in Psychology August 1, 2019 Poppy la Schoenberg, David R. Vago 59 citations

The exploration of human consciousness, specifically how brain structure and function produce the mind, remains a frontier in neuroscience. Mindfulness and contemplative practices involve systematic mental training that can develop the mind in quantifiable ways. While some electrophysiological markers of meditation have been identified, fundamental questions remain: how to classify discrete 'mind states' of consciousness in line with phenomenological experience for ontological quantification; what measures best represent such classification; and whether current electrophysiological approaches can map developmentally specified mind states to neurobiological substrates, given ongoing debates about EEG band functionality and underlying mechanisms.

The Self-Pattern and Buddhist Psychology

Mindfulness April 11, 2023 Shaun Gallagher, Antonino Raffone, Aviva Berkovich-Ohana et al. 49 citations

Buddhist psychology's insights into mind-body phenomena and non-self align with the pattern theory of self, which describes the self as a dynamic, temporal, and enactive pattern of processes. Although Buddhist concepts do not map directly onto the self-pattern, both frameworks share similarities in explaining experiences of self and non-self through pragmatic, relational processes. This mutual perspective offers implications for well-being and flexibility that reduce anxiety, attachment, craving, and suffering.

Can enlightenment be traced to specific neural correlates, cognition, or behavior? No, and (a qualified) Yes

Frontiers in Psychology January 1, 2013 Jake H. Davis, David R. Vago 43 citations

Contemplative science has grown rapidly but mostly ignores the original soteriological goal of enlightenment, focusing instead on stress reduction and clinical health. This is a serious oversight because mindfulness practices in traditional Buddhist contexts aim at profound transformation across ethical, perceptual, emotional, and cognitive domains. Short-term interventions as brief as a few sessions already produce neuroplastic changes, suggesting that even secular practitioners may develop states and traits linked to progress toward enlightenment. To properly assess meditative interventions, it is essential to investigate whether enlightenment can be traced to specific neural correlates, cognition, or behavior.

Pattern Theory of Selflessness: How Meditation May Transform the Self-Pattern

Mindfulness August 1, 2024 Aviva Berkovich-Ohana, Kirk Warren Brown, Shaun Gallagher et al. 22 citations

A selfless state of consciousness, reported for centuries in wisdom traditions, involves both temporary and lasting conditions. In psychology, the healthy self is typically emphasized, and the idea of selfless modes is sometimes dismissed, hindering empirical progress. This paper offers an interdisciplinary conceptual discussion grounded in the pattern theory of self (PTS), which views the self as a complex pattern of dynamically related processes. It proposes that meditative practices induce a reorganization of the self-pattern, enabling temporary or persistent selfless experience. The authors present a heuristic model, the pattern theory of selflessness (PTSL), with six nonlinear transformations: consolidating and integrating the self-pattern; cultivating concentration and present-moment awareness; cultivating mindful awareness; self-deconstruction states; self-flexibility; and self-liberation as a trait. This integrative view advances understanding of non-self experience and guides empirical research.

ENIGMA-Meditation: Worldwide Consortium for Neuroscientific Investigations of Meditation Practices.

Biological psychiatry. Cognitive neuroscience and neuroimaging April 1, 2025 Saampras Ganesan, Fernando A Barrios, Ishaan Batta et al. 6 citations

Meditation practices, which have shown therapeutic benefits for conditions like depression, pain, addiction, and anxiety, have been studied with neuroimaging over the past decade. However, existing neuroscientific models are based on small, heterogeneous datasets, limiting generalizability and replicability. The ENIGMA-Meditation consortium is the first worldwide collaborative effort to conduct systematic meta- and mega-analyses of globally distributed neuroimaging data using standardized methods. This framework aims to improve statistical power and address multidomain heterogeneity in meditation practice types, experience, and experimental design. The consortium will generate rigorous neuroscientific insights into the mechanisms underlying meditation's therapeutic effects on psychological and cognitive attributes.

The effect of mindfulness‐based programs on cognitive performance across the lifespan: A systematic review and meta‐analysis

Alzheimer s & Dementia December 1, 2020 Tim Whitfield, Thorsten Barnhofer, Rebecca L. Acabchuk et al. 6 citations

A systematic review and meta-analysis of 46 studies examined whether mindfulness-based programs improve cognitive performance across the adult lifespan. When combining healthy and clinical studies of working-age adults (18–65 years), there was no significant effect of mindfulness training on cognitive performance compared to control conditions. However, a small but significant positive effect was observed for older adults (over 65), including those with subjective or objective cognitive impairment. The cognitive domains most frequently measured were executive function and attention. The findings suggest that mindfulness-based programs may confer cognitive benefits primarily for older adults, with no evidence of benefit for younger populations.

Moving beyond mindfulness: Defining equanimity as an outcome measure in meditation and contemplative research

October 3, 2019 Gaelle Desbordes, Tim Gard, Elizabeth A Hoge et al. 6 citations

Equanimity, an even-minded mental state toward all experiences regardless of their pleasantness, is proposed as a key outcome measure for contemplative research. While mindfulness has been used as a measurable outcome of meditation, it encompasses multiple components, some better characterized as equanimity. The article defines and discusses the inter-relationship between mindfulness and equanimity from classical Buddhist and modern psychology perspectives, reviews meditation techniques for cultivating equanimity, and examines psychological, physiological, and neuroimaging methods for assessing it. Equanimity captures potentially the most important psychological element in improving well-being and should be a focus in future research.

Mapping Meditative States and Stages with Electrophysiology: Concepts, Classifications, and Methods

October 18, 2018 Poppy L A Schoenberg, David R. Vago 5 citations

How the finite biological structure and function of the brain gives rise to the seemingly infinite expanse of the mind remains a final frontier in basic neuroscience. Contemporary mindfulness and other contemplative practices involve systematic forms of mental training that develop the mind in specific and quantifiable ways. Key questions include how to classify discrete and developmentally-specific mind states of consciousness in line with complex phenomenology to yield ontological quantifications, what measures best represent such classification systems, and whether electrophysiological measures can map developmentally-specified mind states and stages to neurobiological substrates based on extant contention regarding EEG physiology interpretation.

Changing Minds: A Pilot Feasibility Study of Mindfulness Training for At-Risk Adolescents

National Youth Advocacy and Resilience Journal September 1, 2021 Hanna Culang, Elizabeth L. Davis, Laura Egan et al. 4 citations

A nine-week school-based mindfulness program, combined with cross-course curriculum material, helped at-risk high school students build social-emotional resilience over a semester. Students attending a transfer school designed for those who had dropped out or fallen behind showed improvements in self-reported attention control, trait anxiety, coping, and emotion regulation. Those who also participated in the science curriculum component tended to have better academic performance. The findings suggest that mindfulness-based interventions delivered in school settings can promote positive outcomes for youth with reduced access to social, mental health, and educational support.

How Does Mindfulness Affect Cognition? A Reflection on Confounding Issues Surrounding Mindfulness-based Intervention Research Targeting Cognitive Outcomes

November 2, 2018 David R. Vago, Resh S Gupta, Sara W. Lazar 3 citations

A systematic review of randomized controlled trials examined whether mindfulness-based interventions improve cognitive functioning. The authors identify three confounding issues in the existing evidence: unclear criteria for what qualifies as a mindfulness-based intervention, limitations of the cognitive tests used, and variable methodological quality of trials. These problems can distort interpretations of data. The review offers recommendations for improving research on mindfulness and cognition, rather than reporting a definitive finding about cognitive effects.

ENIGMA-Meditation: Worldwide consortium for neuroscientific investigations of meditation practices

April 8, 2024 Saampras Ganesan, Aki Tsuchiyagaito, Greg J Siegle et al. 2 citations preprint

Meditation practices, which have been adapted into manualized interventions for conditions like depression, pain, addiction, and anxiety, show therapeutic promise, but their neuroscientific basis remains unclear. Current neuroimaging studies rely on small, heterogeneous datasets that vary in practice types, participant experience, clinical targets, and imaging methods, limiting generalizability and replicability. To address this, the ENIGMA-Meditation consortium was formed as a global collaboration to conduct systematic meta- and mega-analyses of distributed neuroimaging data using standardized methods. This framework aims to improve statistical power and rigorously characterize the neural mechanisms underlying meditation's effects on psychological and cognitive attributes, advancing the field of contemplative neuroscience.