Mindfulness: does it really work?

Mindfulness and the Emergency Healthcare Professional

Chapter 4: neuroanatomical changes with meditation

So where is the science to prove the value of mindfulness?

In short, there is prolific scientific evidence in the research literature of neuropsychology, and a whole interdisciplinary field of meditation science called “Contemplative Neuroscience”. 

The nexus between modern clinical psychology and both Eastern and Western contemplative traditions, continues to generate large amounts of good quality peer-reviewed data. Review the links in Chapter 1, especially those of Dr Craig Hassed.

Below are two article excerpts detailing the neuroanatomical changes:.

Mindfulness training is a widely accessible activity which is deeply rooted in centuries old Buddhist meditation practices. Scientific inquiry into understanding the neuroscience behind this ancient spiritual practice, specifically, “Contemplative Neuroscience” has applied leading-edge neuroimaging techniques showing that regular, mindfulness meditation practice increases aspects of brain function and structure that tend to decline with normal ageing.

This includes areas in the prefrontal cortex, responsible for organisation, planning, and attention, as well as the hippocampus, responsible for learning and memory, all of which tend to decline in size and activity over time.

Additional supporting research shows that mindfulness meditation strengthens brain activity and connectivity, psychological well-being, as well as brain volume. These data indicate that meditation can counteract memory issues and general cognitive decline associated with Mild Cognitive Impairment and dementia.

Sarah McEwen, 2020

The effects of meditation/mindfulness are related to regularity of practice, and as we discussed in earlier articles this practice can be either as scheduled sessions, or ‘on the run’.  Benefits are achieved through both.

Intuitively, it makes sense to schedule in a daily or even twice daily practice session of mindfulness

Combating regular stress is critical to healthy ageing. When not regulated or controlled, stress can contribute to inflammation, [exacerbate] neurodegenerative factors, [cause] excess cortisol secretion, and lead to an overall increase in risk for dementia and cognitive decline.

Meditation can stave off the negative effects of stress, and increase neuroprotective compounds in the brain, such as brain-derived neurotrophic factor (BDNF) and [thereby assist in] boosting cognitive reserve.

A 2014 JAMA review article found that amongst 47 well-conducted studies of structured meditation training, short meditation programs of about 8 weeks lead to reduced anxiety, depression, stress, pain and improved quality of life

Sarah McEwen, 2020

Scheduling these sessions is also a statement of how much we value our own mental health, and our own inner growth and development. 

We are important. We are not just healthcare professionals, or FACEMs, or nurses, or paramedics, or clinicians, or students, or spouses or partners…

The evidence suggests that our function in all these other roles will be enhanced as we incorporate mindfulness into our lives

So the anatomical changes from mindfulness are related to a diminishing emotional reactivity to stress – the hippocampus actually shrinks in size on MRI scans of regular meditators – which is another way of saying that we are less likely to operate in fight or flight mode when confronted by situations or people that previously would have triggered this reaction in us. Our brain no longer needs this basal reactive functionality so the nucleus regresses anatomically and physiologically.

Further, our ability to think and react calmly in such situations is enhanced – the prefrontal cortex thickness progressively hypertrophies  – which is our calm, executive functioning centre associated with creative and reasoned solutions to events.

Ideal meditation times are something to experiment with yourself; early mornings may work well for some, but I prefer evening. Try and make it nearly every day; if you forget to meditate for a few days, the level reached has to be regained again, certainly in the early stages of practice. 

What will also happen with regular practice is that you will catch yourself starting to react in your previous default mode, identify this, and be able to quickly terminate that reaction, and choose to react mindfully instead. Less irritability, less anger, less fear.  And this “reset process” gets quicker and automatic, with practice.

Research has shown that becoming more aware of your mental states increases activity in the prefrontal cortex and helps you better regulate your emotional center in your brain (the amygdala). Additionally, the dorsolateral prefrontal cortex (the CEO of the brain) works in concert with posterior regions in the brain to help seasoned meditators strengthen the brain network that allows us to pay attention to a task at hand and ignore distractions.

Sarah McEwen, 2020

Next time is ‘decision time’…Does mindfulness and meditation intuitively appeal to you?

Take care of yourself and thanks for reading this.



Further reading

Waiver: These articles represent my own views and approach to mindfulness, and do not purport to be the official view of ACEM.  They are not intended to replace appropriate medical or mental health care, provided by professionals in these domains

Cite this article as: Andrew Dean, "Mindfulness: does it really work?," In: LITFL - Life in the FastLane, Accessed on December 1, 2021, https://litfl.com/mindfulness-does-it-really-work/.
A/Prof Andrew Dean, MBBS FACEM Grad Cert Clinical Simulation. Emergency Physician and DEMT at St John of God Hospital, Ballarat, Victoria, Australia. Head of Ballarat Rural Clinical School, School of Medicine Sydney, University of Notre Dame Australia.
Still searching for new and innovative teaching methods for emergency medicine education.  Also a committed advocate for mindfulness meditation, and the nurturing of emotionally intelligent clinical teams in health care.

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