 Welcome everyone to this session on the human brain. This one is called Deconstructing Mindfulness, and it's obviously a topic that a lot of people are interested in these days, and I think we have a great session prepared for you. Our two speakers are Richard Davidson. He's the William James Enviolus Research Professor of Psychology and Psychiatry at the Center for Investigating Healthy Minds, Weisman Center, good, University of Wisconsin-Madison in US, and also Tom Insel. Tom is the Director of the National Institutes of Mental Health, and all that that implies. So we're going to have a chat about this, and actually we will be taking questions, so if you have some feel free to join in. But Richie, I thought we should start with you. Tell us what we're talking about. We're deconstructing mindfulness. Let's reconstruct it and talk about what we're talking about. Well, mindfulness, actually to quote my dear friend who is one of the experts in the audience, John Kabat-Zinn, has said that mindfulness is paying attention on purpose, non-judgmentally. That's one definition. Mindfulness is about being present in the present moment, being fully aware in the present moment, being able to absorb and to process all of the information that is accessible to an individual in the moment that each individual has, which is just the present moment. It is the only moment we really have. And one of the ways to think about this is to contrast mindfulness with some of its antithesis, such as mind wandering or mindlessness, a recent study published in a prestigious journal, Science Observed People in the Real World. And they queried them with text messages and asked them several questions. They asked them three questions. This is in a group of several thousand people. One question was, what are you doing right now? And the second question was, where is your mind right now? Is it focused on what you're doing or is it focused elsewhere? And what they found is that, on average, the average American adult spends 47% of her, his waking life, not paying attention to what they're actually doing. And mindfulness is really about bringing our attention back to the present moment and not getting carried away by our thoughts or our emotions, which often hijack our attention and bring us away from this present moment. Now interestingly, in this study that I was referring to, the third question they asked was how happy or unhappy are you right now? At the moment the question was asked and they found that when individuals reported that they were not in the present moment, they were less happy than when they were in the present moment. And so there is some association between reports of wellbeing and happiness and being in the present moment. So I'm very intrigued by this notion of attention because as you were speaking, I was imagining my children, as they sometimes do, sit in front of the computers playing a game and their attention is exquisite. I mean, the house could burn down and they would still be firing away. Tell me the difference between that kind of attention and the attention you're talking about. Yeah, it's a great question. And what I would say is that the kind of attention that you're talking about, we would say is stimulus driven or stimulus captured attention. And in fact, this is something that's been studied in the laboratory. People, in addition to playing video games, people put themselves at great risk to focus their attention. There have been studies of rock climbers, for example, who engage in activities that have been described as producing flow where there is a feeling of being completely in the present without distraction and where a momentary lapse of attention can actually potentially be lethal. And the invitation in the work that we're describing is that it is possible to actually be in the present moment without engaging in those kinds of extreme activities. It's possible to cultivate this quality in one's waking life all the time. One doesn't need to be playing a compelling video game or being involved in a engaging task or rock climbing. We can actually educate our attention. And this is actually something that William James, more than 100 years ago, said so eloquently in his two volume tome, The Principles of Psychology. And if I can just quote William James, he said, the faculty of voluntarily bringing back a wandering attention over and over again is the very root of judgment, character, and will. And he went on to say that an education which should improve this faculty would be the education par excellence. But it is easier to define this ideal than to give practical directions for bringing it about. That's what William James said. And I think if William James had some contact with the traditions that we're describing today, I think he would have instantaneously seen that these are vehicles for educating attention among other things. I haven't forgotten about you, but I wanna ask Richie one more question. What makes this topic right now so gathering so much attention is people have begun to see this as an avenue to all sorts of healthy lifestyle behaviors and health and wellbeing, however you want to define it. What part of that equation interests you? And is that what you're studying in your lab? How this, I mean you can describe this behavior, but the interest seems to be for its positive benefit. So what do you study there? It's a wonderful question, Joe. And if the impact of mindfulness practice was restricted to the periods of formal practice, it wouldn't be very interesting. It would be like taking a drug which then had its effects dissipate. We're really interested in the longer term consequences of these practices. And so there is a lot of scientific research that's now going on to investigate its impact on wellbeing, to investigate its impact on certain aspects of health. And this work is really at a very, very early stage. And I think it's important not to over promise and oversell the state of the research at this point in time. There is still a lot to be investigated, but there is some evidence to suggest that these practices may be helpful in reducing inflammation. These practices may be helpful in treating as an adjunct certain psychiatric disorders such as mood disorders and anxiety disorders. But again, the evidence is still in its infancy and we still have a long way to go. Okay, so Tom, having brought the health aspect of it into play, the National Institutes of Mental Health presumably has some interest in this among other approaches. Where do funding agencies sit in terms of their interest in pursuing this as a tool to better mental health? Before coming, I thought I'd better get educated about this topic as I know much less than Richie and many of the people in the audience. So I did what we all do. I went to PubMed to see what was there. 498 publications as of last week on mindfulness slash meditation and brain. So there's a lot of research going on. Now our interest on the mental health side, in addition to whatever people are working on with respect to immunology and health, other aspects of health, we're really thinking a lot about issues around depression and anxiety. And I think what gets us there actually was introduced by Richie in a very clear way that if you think about what is depression, what is anxiety, it's a lot of things. And it's clearly these are brain disorders. But in terms of subjective experience, people when they're depressed are mostly locked in the past. They're ruminating about something that happened that they can't let go of. When they're anxious, they're ruminating about the future. It's that anticipation of what they can't control and they angst about what might happen. What Richie talked about was how to focus on here and now. And if you could train yourself to do that in a way that was rigorous and would be able to continue after the moments of training, just as you've said, that begins to sound like a very important vehicle and a very important part of what it takes to recover from these are really debilitating disorders. So that's where we come from Joe. We sort of think about, can this be an adjunct to everything else that people are trying as part of a recovery process? And the evidence while it's still accumulating is pretty good. It's always hard to tell because there's a kind of publication bias. You tend to see people publishing work when it's positive and less likely to publish when something doesn't work very well. So you have to be a little skeptical when you look at those 498 papers. They're almost all positive. That doesn't sound like reality. Nevertheless, that's the way science moves forward is by collecting that kind of information. What would you, I mean, would you care to speculate on the reasons for the long-term benefits if it's not something that's just in the moment but that it carries forward? Is that something that you would have an explanation for? Because I can ask Richie too. Yeah, so this is a great part of what I think we can get into a little bit. And again, I'm going to turn to Richie to get some of the details. But, you know, Davos has had a tradition of, especially this year, focusing on the brain and also focusing on mindfulness. And so here we are, bringing these two things together a bit. And of course, the question you're asking is, is there something about this training that changes the brain that has lasting effects on brain function and then lasting effects on the mind? And the evidence there is actually pretty interesting. Again, I think you have to be aware of the publication bias. But one shouldn't be too surprised if you learn to juggle or you learn to play the piano or you learn another language. Anything that requires acquiring a skill changes brain pathways long-term. And you can see that happen within an individual. So there's every reason to think that mindfulness training or any kind of contemplative training would do the same thing. And in fact, the evidence is really pretty terrific for that. There are differences depending on the kind of practice that you do. There are different pathways that are affected, depending on whether you're really focusing mostly on internal states. And then you get these interceptive pathways that change and they change long-term. If you're focused more on an extra-acceptive, on listening to your sensations and your body and what's coming in, that actually changes a different set of pathways. But the data are really quite interesting, just as with any other kind of motor skill learning, this kind of what we call metacognitive learning, learning to watch your own mind, learning to actually be introspective in that sense, does have an impact on brain pathways long-term. And there's every reason to think, therefore it may also carry over into all the things that you do when you're not in the training session itself. So I can understand why a neuroscientist would be drawn to this problem, but what drew you to this question of what's happening in the brain as it's changing because of mindfulness? Well, in terms of my own personal story, Joe, really what honestly drew me was meeting people who were engaged in this practice, whose demeanor and whose presence, whose warm-heartedness was very infectious. These were the kind of people that I wanted to spend more time around and for the most part, they weren't the people I found in the academy. How can that be? What academy are you talking about? Just to be clear. Okay. You're not naming names. All right. So that drew me initially and I learned more about it and then my life changed quite dramatically in 1992 when I first met the Dalai Lama and he challenged me and he said, look, you've been using tools of modern neuroscience to study anxiety and depression and fear. Why can't you use those same tools to study positive qualities of the mind? And it was really a simple question and there was no good answer I can give other than it's hard. But when we first started to study fear and anxiety, that was hard too. And I think most neuroscientists would agree that we've made at least a little bit of progress on understanding the brain mechanisms that underlie fear and anxiety. So that was a wake-up call for me and an invitation to begin work in this area. And if I can just go back to give a very specific example to follow up from Tom's comments, a really good example is with pain. This is something that all of us have experienced with physical pain. And there are some wonderful experiments that have been done on the application of mindfulness and pain. And so just to give one simple example, in the laboratory we can use a thermal stimulus, heat, to produce extremely realistic pain and deliver it in a way that's very safe. And we can present a cue to a person after she or he experiences this pain initially and the cue indicates that in a few seconds you will be zapped with this very intense heat stimulus which will produce physical pain. And then the stimulus goes on and then there's a period of recovery. So we have three periods here, an anticipation period, a period during which the painful stimulus is delivered and a period of recovery. And what we find is that when we present the cue which tells a person that she or he is about to get a painful stimulus without any pain being delivered, the networks in the brain that we know respond to pain begin to activate immediately. And it's as if they were presented with the actual painful stimulus. In individuals who've engaged in long-term mindfulness practice, there's very little change in the brain until the actual stimulus is presented. Then there's a very big change. And then in this recovery period after the stimulus is delivered, the untrained individual continues to show reverberation in these networks that are pain responsive. It's as if the pain is continuing. But among the long-term mindfulness practitioners, they go back down to baseline very, very quickly. So this is an issue that Tom and I have both been speaking about. There is a very dramatic change in the anticipation period and in the period where a person may be reflecting on the past. And so the mindfulness practitioner is showing an appropriate and large response to the stimulus itself, but is showing very little activity in these bracketing periods. And it turns out that the activity in those bracketing periods, the anticipation and recovery periods, account for a lot of subjective distress and unpleasantness. Can I add a great example? One that might even resonate more with some people here is that you don't have to be apparently a long-term practitioner or a monk. A wonderful study was published last year, I think it was in JAMA, or it was in JAMA psychiatry, looked at four platoons of marines in the US and four platoons who got eight weeks of mindfulness training about four hours a week in class with homework and then a control group of four platoons that got none of that and got some other sort of non-descript didactic work. They went through basic training at the end of eight weeks, they went through an intensive stressor as part of their overall training. And the question was whether mindfulness would have any impact. And actually, when you look carefully at the data, it doesn't have an impact on heart rate or respiratory rate, all those things go up a lot in both groups. It's the recovery phase, really striking and the immune response to this stress that's really strikingly different. And in this case, they actually did neuroimaging and found different degrees of activation of particular brain pathways. Again, what that means is open to debate, but that's after eight weeks. And men who were not looking for this but were assigned randomized to receive it, so it, again, the effects aren't huge, but they are significant and one wonders whether longer training, people who may be more incentivized, whether it would make even a greater difference. Actually, I was gonna ask that something along those lines, is there a difference between the mindfulness as practiced by monks and the Dalai Lama and the mindfulness that you would ask a human subject who wasn't involved in that kind of training to perform? Are they essentially the same thing? It's just the duration of experience is longer or there's something different about the research version of mindfulness versus the religious tradition of mindfulness? Well, I would say that they share fundamental similarities. Obviously, there's a huge difference in dose, so to speak, but they share fundamental similarities. And I think that there are many wonderful examples of mindfulness practice being taught in a completely secular way, but in a way that captures, I think, the essential ingredients that have been practiced by these very long-term practitioners of the sort that you described. So I don't think there's any fundamental difference in kind. I'm gonna turn to the audience in just a minute, but I have one more question and that's a sort of a philosophical one. How important do you think is it to know what's happening during mindfulness or what the effects on the brain of mindfulness are? In other words, it works for people who practice it and are favorably impressed by it and you can operationally describe the decrease in heart, you know, in anxiety or other things that you wanna measure as a positive outcome. What's the value of knowing, okay, the prefrontal area or the cingulate or the limbic system is involved? Where does that get you? Can I take that, because we get that question a lot as a funder and we do support some of this research. And so I start from a rather cynical perspective, or a kind of anti-neuromaterialist perspective. I don't think showing a change in the brain is either necessary or sufficient for a subjective experience, right? So I don't think you need the brain studies to validate or to falsify whatever it is that people experience when they're going through the training. But the two things about the brain that every person with one should think about, the first is that unlike, in contrast to virtually every other organ of the body, this is an incredibly metabolically active organ. It's 2% of your body weight and it's 20% of your metabolism. 20% of your oxygen consumption, 20% of your metabolic demand is in the brain. So it's like your heart would be at a very, very high rate. That's what your brain's doing at rest. And one of the great discoveries of the last few years with neuroimaging is the very high level of activity in the brain at rest. There is no true resting state. In fact, what happens with the intentional engagement is often you slow that down. And that's the second thing you need to think about with your brain is that the brain cells you have, they're all you get. Unlike virtually every other part of the body, there's no regeneration. And what makes that is that we live a long time. So that means you've got to have cells that are going to hang around for at least 80 years. Our cells really aren't built for that for the most part. That's not the way human biology has been geared. It hasn't been geared for those very long time scales, especially when there's a huge metabolic demand. So I guess a question you'd ask is, is there some way to give a little bit of relief to an organ that is always in demand, especially when it's mind wandering, especially when it's at rest. Because what we think about as rest for the rest of our bodies is actually a surprisingly demanding state for our brains. And if this is some way, and I don't know that it is yet, that's where my cynic comes out, but if this is a way that just for a few minutes or even in a more chronic way for 5% to bring down that very high demand state, maybe that's useful and good to know about sometime fairly soon before you hit that 70 to 80 year mark. But now I'm curious, are there studies that show that blood flow to the brain decreases or oxygen consumption decreases during a state of mindfulness, do you know? There are studies which show that there are changes in blood flow. Interpreting it however in the sense that Tom described as giving the brain a rest, I think at this stage is still open to question. I think the question that Tom poses a very important one. But if I can just add one other thing, I think that there is another reason why the study of the brain is potentially very important and that is that one of the things that we're learning in many areas of medicine and it applies to this area as well, is that it's very likely that one size does not fit all. And I think that it's, we really know very little about how to prescribe individually in a way that can maximize the effectiveness of these practices. We don't even know for example, if a person practices for 20 minutes a day, is it better to practice in two 10 minute sessions? Is it better to practice in a single 20 minute session? Is it better to practice in 10 two minute sessions that are sprinkled throughout the day? We have no idea. And there are ways in which the study of the brain may be informative to help make more individual prescriptions if you will based upon individualized patterns of brain activity. And so that's something that is being pursued now in current research. Well I said I'd like to engage the audience and I do and I will take a question but before I do, can I ask how many people in this room have tried some form of mindful meditation? Okay, so we have an engaged audience. Okay, yes sir, I think I'd like to know. My question is basically when you say practice a state of mindfulness, what is it you're referring to? Is it just breathing? Is it meditation? Or if you could just talk a little bit about the state of practice of mindfulness. Well one can be mindfully aware of anything. So what we're really talking about is dedicating one's full awareness to the present moment and it could be awareness of the breath, it could be awareness of external sensations, it could be awareness of thoughts, it can be awareness of emotions but the idea and the invitation is to become aware without getting carried away in the narrative, being aware in this flavor of non-judgmental kind of awareness. And so there are many different ways to practice and we do not yet know from a scientific perspective what the differences among these objects of focus might be and again there may be important individual differences in what may be maximally helpful for any given person. Yes, go ahead. Hi, I'm curious as to whether there's any research that's going on in attention deficit disorder or ADHD, particularly in the pediatric population and whether there's any studies going on in this group and whether that might be something useful in lieu of medications. Yeah, I can speak a little bit to that. If you were trying to find a group that would be the most challenging to get through this kind of training you might have just mentioned it and it's very difficult for children who can't focus to be able to do this all the more important to make this part of what you ask them to do. It's one of the situations where it might be interesting to think about actually using medications to help them do the training and then be able to wean off the medications once they get to a point where they have more of what we would call cognitive control or there are lots of ways of describing this but the ability to actually rein in impulsive thoughts rein in the kind of wandering that Richie talked about. The evidence right now is pretty good. I mean, there are now examples of that and there's a lot of interest actually in developing devices providing a kind of neuro feedback for kids and turning those into video games that would allow kids to be able to get engaged and learning cognitive control. It's not too difficult to understand that if there's a neural signature as we're suggesting to this process that you provide a lot of feedback around when that signature shows up with an EEG and then kids would learn that the same way they can learn to control heart rate or breathing rate. So that's still I think in the experimental phase but it's promising and it's one way to look forward to having not maybe instead of medication but in addition to it's part of the toolkit that you could offer. And if I can just follow up on that, the Gates Foundation recently gave us some funding to do exactly what Tom is describing and we've developed a video game that's targeted for middle school children to teach them simple skills of mindfulness in a game-like format. And we've been rigorously investigating that in a randomized controlled trial in a way that you would investigate the impact of a pharmaceutical both on aspects of attention as well as on the dose of medication that they're taking. And so this work is ongoing now. So I don't have any findings I can report but there's enough out there I think to warrant serious scientific scrutiny of this possibility at this point in time. Yeah, I should just add one thing. Last year when we had a similar conversation Goldie Hahn was here and talked about the work her foundation is doing not so much for ADHD but for children in general they've taken a similar kind of training for third graders into eight states and they have done a fairly large-scale study which looks at improvements actually in academic performance and there's something there. So if you're interested the Hahn Foundation is probably the leading edge of what's being done on a large scale. They still need to do a very large scale randomized controlled trial but the evidence is beginning to show up. Patients have depression which is very common amongst women particularly. Does mindfulness training work better with the medication or less? Because you're doing something which helps the depression. Any medication that commonly use ones and this mindfulness actually work in synergy or it works against it. So I don't know evidence about doing a specific comparison of plus minus as an augmentation you may know more about that. Yeah, I don't think there's been a study directly addressing what you're asking. There are good data now on mindfulness-based cognitive therapy with depression and the best evidence suggests that if these interventions are given to depressed patients when they're admitted there is good evidence to suggest that they decrease the likelihood of relapse and that's where the best evidence is on the application of mindfulness practices in depression. In terms of the synergistic use of these practices with medication to the best of my knowledge those data don't yet exist. It's a good question and it's something we should actually think about. We don't ask people to train for a marathon when they've broken an ankle and you try to get that fixed and then you expect them to train. In this case if the training itself would help the healing it would be worth knowing but when people are severely depressed I think it's gonna be very difficult for them to practice cognitive control until they can get to a point where they've got at least some control some handle over the anxiety and despair which is because this is a really, really tough illness but the idea that you could then bring this in and certainly cognitive behavior therapy has been shown for years to be highly effective for even moderate and even severe depression but whether mindfulness could add to that is still, I think, unproven. I've got a question back there. Would either of you think we're at the point where you could make the case that mindfulness training ought to be a part of education in the way that physical education is part of education or literacy training? Well, I'd be happy to take that initially. From where I sit I would say absolutely yes. I think that we talked a little bit about attention and going back to William James I think training attention is the building block for all other forms of learning. If we're not paying attention to the information that is being presented it will compromise our ability to acquire any kind of knowledge and so we've just published an initial paper where we have done some of the things that Tom was mentioning that Goldie Hawn is doing where we've developed a curriculum for preschool kids and we believe we can start this early. This is kids four and five years of age where we teach them simple skills of mindfulness and also of kindness and pro-social behavior and this was part of a randomized controlled trial where we randomized kids by classroom and we see very substantial gains after a 12-week curriculum and after a six-month follow-up in these children as a function of this kind of curriculum including grades that are being assigned by their regular classroom teachers. So I think that there is definitely a role for this but I also wanna emphasize that the evidence at this point in time is very, very meager and I think that we need to do much larger studies in much more diverse samples before this I think will get incorporated in a more widespread way. David, the only thing I had to add is because I completely agree with Richie's statement I suspect good teachers do some pieces of this already. Ask students to get centered, take a breath, let's focus, put away the cell phones, put away everything. That's part of what we're talking about. We put a label on this and it sounds sort of magical but actually this is what all of us do to some degree. I think by labeling it and structuring it we can maybe do it far better. I sometimes think about this like learning to play the piano. I mean any of us could probably go in and be able to pick out something but this is about probably doing that in a more formal structured way and certainly education is one of the places where this kind of attentional training is gonna be extraordinarily important. I think it always has been. We just haven't perhaps given it the same kind of moniker. I'm just thinking maybe we should try this with the U.S. Congress. It seems. I just, one question, can you overdo it? Is there a limit to it? Do you have any? Is there too much mindfulness? I wonder it's like having too much with a video game where you're doing such a good job that you notice that the world is going, no nevermind that's not true. I think that there are contraindications. I think that Tom mentioned patients who are severely depressed or psychotic patients. I think that if one is not careful in those situations there are situations where any amount potentially can be deleterious and so I think it needs to be applied judiciously. In terms of in normal samples, whether there's too much, I think that what you would hear from a long-term practitioner for someone like the Dalai Lama is that he's in the present moment all the time, 24-7. I would say that there's no such thing as too much in that case. It's really just being utterly present and appropriately responsive and it comes spontaneously with a certain level of training. So I guess for those who are kind of new in this space, I would just caution against self-absorption and narcissism, which there's a little bit of that at Davos, so I can probably safely bring that into play here. I mean, you don't want to do this. You want to do this as a vehicle to being open and to being attentive to others and when it becomes a way of tuning out and only attending to oneself, I'm not sure that's progress. And I should just say that when this is taught in an authentic way, when a person sits down to practice, she or he invokes the intention that they're engaging in this practice primarily not for themselves but primarily to be of benefit to others. It is with this altruistic motivation, which is something really important. Yes, go ahead. I'm a physician at NYU. It's really interesting. Everything you've been talking about is so fascinating and I think that within the community, there's just more and more sort of general knowledge about meditation and mindfulness and I hear it more and more just from people coming in and your talks about treating depression and anxiety with it, but I don't find there's lots of resources for people to just really, for them to go to to learn how to do this. And I was wondering if you could just speak to, as this evolves, are there, what kind of practitioners or what kind of teachers or people could you, aside from like a psychologist or someone that you could seek out to to learn how to be a more mindful or how to meditate better type of person? Well, we have in the audience, John Kabat-Zinn and whenever anyone asks me where they should go first, I always tell them John Kabat-Zinn and mindfulness based stress reduction. It really, full disclosure, I've been very good friends with John for more than 40 years, but this is probably the most well-investigated method of teaching mindfulness in a secular way that we have. And it is done, in my view, very authentically and very carefully. And so, and it's very easily accessible. It's taught at virtually every academic medical center in North America and in Europe. And so, I think it is a very good place to start. Having said that, there are also many other resources. And at NIH, if you go on to the website of, I forget what the new name for it is, it used to be the National Center for Complementary and Alternative Medicine. It's now- Alternative and Integrative Health. Thank you. The National Center for Complementary and Integrative Health. Which has a non-pronounceable acronym. Yes. So, on that website is a whole set of resources related to meditation that is presented in a scientifically framed way. And I think that that's another great resource to go to. Yes, sir. When we be talking about mindfulness, it is being about meditation where you are trying to control your thoughts and focusing them or bringing them to a stillness. What about mindful action? Where the thought is in one moment and the action is a few moments later. So, how do you practice the thought of being in mindful action? You know, I would say that you can be aware, you can be mindful of thoughts, you can also be mindful of actions. And one of the ways in which mindfulness is taught actually is through movement, through action. Mindful walking, for example, is a very commonly taught practice. And so, it is not necessary for a person to be still to learn, to bring mindful attention to whatever he or she might be doing. And in fact, when we teach this to young children in the classroom, it doesn't resemble your stereotype of what a mindfulness instruction might be for an adult. The kids are moving a lot. That's what kids do. And so, the invitation is to bring mindful awareness to what they spontaneously do, which is to act. Any question? Go ahead. I'd just like to share with the audience an experiment we're doing. We started about eight years ago. We now have a million children in middle and high school. And the focus was to do a test to see if mindfulness training and metacognitive skills, pro-social skills, works. We are in 11 countries. We have a million children in the test. And what we found is with children at that age, teenagers, it's very important to link mindfulness training with some other concepts like leadership, ethics, altruism, and so on. So it makes them less self-absorbed and it actually gives them a reason to lead from within rather than looking at an internal process as something in itself. And by that connection, we're actually finding a tremendous response. So to give you an example of that response, at one of the schools we're active in right now through our foundation, the student body elects its leaders. And they have now started to elect leaders. The principal called us and said, we've noticed a change in the last five years. We're doing this program. It's a continuous program for the entire school. It's not a 12-week intervention. It's a continuous program through the entire school period. And they said the children are now choosing their leaders, their school leaders and their student leaders. They're looking for different types of leaders. They're no longer choosing the most popular boy, the best sportsman, et cetera. They're looking for people that are aware, conscious, pro-social, and have ethics and altruism in the way they will lead. It's an interesting little outcome. Thank you. We only have a couple more minutes and I wonder if I could put John Kabat-Zinn on the spot here since his name has come up. Having heard this discussion and having been involved in this for a long time, where do you, what do you feel hearing this about the direction that this field is going and where it might take us? Well, I love it. I think it's wonderful to be having conversations like this. I think it's really important to underscore what both Richie and Tom have said that we don't want to get too far out ahead of the data and begin to sort of talk about mindfulness as if it was the next big thing to hit the planet. I think that's the best way to destroy what's deepest and best in it for the long haul in terms of its potential promise for humanity. So I think there's an enormous amount of work to be done to study it of the kind that Richie and his group are doing and many other groups as well. And that of course, if you plot the number of papers in the scientific literature over the past 30 years on the subject of mindfulness, it goes along at a very, very low rate, some years no papers at all. And then about the late 1990s, it starts to go up. And then cognitive, mindfulness-based cognitive therapy came into play and a whole bunch of other accelerants, which we can talk about, including the neuroscience. And then it's now going exponential. I think the funding needs to follow a similar curve. I imagine that it is, although I don't know that. And the kind of rigorous science really needs to be applied to it so that we can be very confident in what we're talking about. On the other hand, I do think that there are certain elements of this that are totally commonsensical and something like titrating the medication down and the meditation up. I mean, we're talking about one change of consonant in the English language. And there's something about it that's tremendously appealing. We've seen this in the clinical domain for many, many years. People actually, in concert with their physicians, not on their own, actually going off their medication for pain, for anxiety, for depression, and so forth. As they begin to learn the self-regulatory elements of mindfulness and discover that the things that used to be symptomatically problematic for them no longer are arising at the same level, I would ask Tom a question. It struck me that you said that as we age, we only get a certain complement of neurons. And I'd love to take the opportunity to ask you about neuroplasticity and what is known at this particular moment about neurogenesis and the laying down of functional new neuronal pathways within the brain, maybe in the hippocampus or in certain regions. Is it actually true that we don't lay down any functional neurons in the brain past the age of two or three? Tom, I'd like you to answer that question in 15 seconds, if you possibly could, because we're just about out of time. It's a great question. But if you can give the short answer, at least we have to wrap up. Yeah, so other than in a very few areas of the brain, neurons are not born, as far as we know, and those that are small in number. But the brain's changing all the time, not through new cells but through new pathways and new connections. All right. Well, I think we'll have to leave it there. This has been a totally interesting session, and I thank you all for making it so and participating. Let's thank our panelists. Bless you, John.