So we have a lot of material to present. These are a lot of kind of, you know, there's a lot to go through, but we can kind of, we can keep it pretty loose and open, like I think discussion is great, so don't feel shy to intervene. So this is kind of a general outline. So we'll start, I mean, we thought that we'd have two parts, but I guess it'll just all be in one shot. But so just kind of talk a little bit about how we think about these different practices and how to kind of conceptually, at a very global scale, think about their relationship. Talk a little bit about hypnosis, suggestion and placebo's, and then transition into thinking about meditation, and then how some of the themes that we talked about, like suggestion and placebo and so on, might actually be more relevant to the science of meditation than people have tended to think. So this will kind of open up into a conversation about narrative and context, expectation, and how they might play a role in contemplative practices and meditative practices. And then thinking about kind of expanding what we think of when we talk about meditation, because the scientific field has really focused on a pretty narrow understanding of what meditation is that's really oriented around kind of mindfulness-based practices. So we'll get into that, and opening up into thinking more about cultivating the imagination and more the kinds of things that we were talking about this morning with Tanya, about kind of interacting with invisible beings and so on. And then we'll kind of, this will all culminate in a rant on the part of Samuel here, which I actually am quite sympathetic to, and it's nice to see that actually a lot of thought seems to be converging to a similar theme, but thinking about how to kind of open this dialogue that's emerged around mindfulness and so on, against what we call the tyranny or the hegemony of the present moment, and this kind of idea that the only meaningful thing is what's happening here and now, and the idea that maybe that's a bit of a simplistic impoverished notion of meaning and human existence. Perhaps I might offer just very brief clarification by way of framing the audience's expectation. So I'm here very modestly, I'll be in the background mostly for this presentation to fill in for Amir Raz, and but also hopefully to pick up on a conversation that I hope to have begun with you all on presenting the cultural affordances model. So during my talk with Maxwell, I spoke very briefly about our experiments and placebo therapeutics as a way to potentially operationalize experimentally the cultural affordances model. So the question was, can we curate the particular context, ecologically and culturally, that sort of activates people's expectations of healing? So my aims today are two sets of aim, very modest ones to have a slower conversation to talk about and try to parse out some of what we call the non-specific effects in healing, in particular the role of interpersonal context, beliefs and expectations and modulating experiences of healing. And then in the second part of the talk, I'll briefly attempt in a more ambitious way to sort of deflate the notions of hypnosis, placebo, suggestion, conjuring imaginary friends. And this deflationary account of all these different processes might enable us to have a conversation about culture more generally, about cultural modulations of attention. And then in the end, what we hope to achieve with discussing the tyranny of the present moment is having established a set of conceptual tools to think about cultural context, to think about the ways in which our attention and our expectations and our experiences are sort of automatically modulated by each other. Can we propose modestly some sort of a diagnosis of contemporary social pathologies? And in particular, we will be asking precise but tough questions about the place of mindfulness culture and the culture of self-care in all of this. Okay, so all of that in an hour and a half, let's go. So I just want to start off. So this is a book that I edited with Amir Raz, who can't be here. This was kind of the culmination of my PhD work, but I just show this slide because it helps jostle my memory. And the kind of the story I always tell is that when I tell people that I'm thinking about hypnosis and meditation, they always ask me, are they the same? Are they different? What are the overlaps here? And I was actually just at a conference put on by the Mind and Life Institute, which is kind of one of the main institutions pushing the science of meditation forward. And it was actually on the relationship between hypnosis and meditation. And what's interesting is that there's this very common tendency to kind of reify or essentialize these categories. So we think that like meditation is one specific thing. So then we ask something like, what is the state of meditation and is that the same or different from the state of hypnosis? But I think that that's a very kind of limited way of thinking about these. So I tend to think more in terms of collections of in culture, like culturally situated practices that draw on potentially similar mechanisms or in some cases different mechanisms. Then so you can think of kind of the context of these practices, how they're understood, the rituals involved in them, and then what kinds of phenomenological alterations or mechanistic cognitive alterations they might involve, and then what are some of the outcomes. And we might have overlaps within these categories and in all of these different levels of thinking about these practices. I really don't think it's useful to think about like what is hypnosis as such or what is meditation as such because these are both really complicated categories. So this is kind of like a very, still very simplistic, but kind of starting to gesture towards the kind of theory that we might have where we might think of something like individual proclivity where maybe some people might be more or less responsive for like personal history reasons or genetic reasons, kind of different cognitive styles. Then you'll have some kind of induction, like a ritual, a training. So often in hypnotic contexts, this is more of like a one-off or maybe a series of hypnotic encounters, whereas in meditation, you'll often get a more kind of long-standing practice over many weeks or years or decades even. And then a kind of cultural invitation. So what are the expectations? What are the kind of stated goals and narratives and the cultural framework or scaffolding that these practices are always situated in? And I think that, so basically if we think about these different mechanisms or kind of sets of ways in which what we, things that are happening here, factors and variables, then we can start to talk about specific instances of things that we might call hypnosis or meditation and actually understand how they work. So maybe there's another thing that's interesting is that the different domains of the different fields, like the science of meditation, I would say has focused much more on the idea of cultivation and like neuroplasticity and the idea that through repeated practice, you can change your cognitive architecture, whereas for instance, the science of meditation or of hypnosis has focused much more on individual proclivity and much more on social context and attitudes that people might have. So I think that actually bringing these sciences together can be really productive to just have a better understanding of this whole domain of how these things operate. So like this is a very kind of classic baseline idea in the science of hypnosis, which is that not everyone responds the same way to hypnotic suggestions. So some people it's kind of more or less a normal distribution. It's fairly stable over the lifespan. So like if you test someone and then 25 years later, you test them again, they'll show relatively stable responsiveness to suggestions. And there's some really standard ways that we assess this trait. So basically you give people a series of hypnotic suggestions.  And then you give them suggestions like that they're gonna feel their hand lifting without any sense of effort. So like it's just gonna lift by itself or that they won't be able to open their eyes or that they'll hear a fly buzzing in the room. And then depending on how much they themselves felt that they were responding to those suggestions, you grade them on hypnotic suggestibility. What's interesting too is that if you, there's kind of two judgments that you can ask someone. So you can ask someone like in the arm levitation suggestion how much did you feel that your arm moved? Did it move more than a few centimeters or did it not move? And that's what we call like an objective measure although it's still actually asking the subject for a self-report. But then there's the other question of how much did you feel that you had agency over that? Because maybe someone moved their arm but actually they didn't really feel like it was happening in an effortless way. Maybe they felt like they were kind of playing along with it to some extent. So that's another way that we can kind of get a hold on suggestibility and because it seems like some people might be responding to the same suggestions in different ways and that might have different underlying mechanisms. So I mean this is just kind of, there's like basically like a lot of this field of hypnosis has been concerned with the question of what can hypnosis really do? Like do hypnotic suggestions actually lead to objective changes or are people kind of just faking it or do people just think they're having a special experience but actually there's nothing really profound happening in their cognition. And so there's different ways that we can kind of try and show more objectively that there are responses that we can induce with hypnotic suggestions that usually people wouldn't be able to recreate or to fake. So one way which is it's kind of a complicated like epistemological question of what's you know with neuroimaging because anytime any experience you have is always gonna be reflected in a change in brain activity. But there are some kind of convincing findings. So like for instance this study, kind of a classic study in the field they actually gave people a physical pain stimulus. So I think they were using like a really hot thermal stimulus that doesn't quite burn you but it really hurts. And then you see this very canonical kind of pain network that lights up in the brain. Or you can induce hypnosis or induce pain using a hypnotic suggestion. And then you see a very similar pain circuit activating. Or you can ask people to just imagine that they're in pain and you see a much less consistent pattern. So there's something special going on we might infer about actually giving this kind of hypnotic suggestion that's not just the same as imagining. Just one quick question I don't want to throw y'all. But some of the experiences that Tanya was describing on that dissociative continuum. And this is the same thing I've seen a lot of trans experiences in India. You don't actually have, there's a kind of amnesia and a loss of consciousness or conscious recall. Seems like that would pose some, I don't know if this is in the same family, maybe some of these, but wouldn't that pose some challenges for them if you're assessing those experiences through a self report, self recall?  Well, if you're in a few kind of trans thing maybe you don't. Yeah, that's actually a good point. Yeah. I don't know. I've never actually really thought about that specifically. Do you have any thoughts about that Lawrence? Like, I mean, most people don't have amnesia and there actually is an amnesia item on the Harvard scale, which is one of the classic scales. Amnesia can be induced. Yeah. With the hypnotics. So there's a suggestion, there's a suggestion where basically you will forget the experiences that you went through until there's a cue. There are many people who score highly on other items, like say, well my arm was moving on its own, wow, and it will not have amnesia. So just in terms of data collection, it's not much of a problem because it's a minority of people who are really having compelling amnesia. It is an interesting notion that you might get a false negative score, something like, oh, it looks like you're bad at this and actually they were just totally, they were the whole thing. I guess the other part of it is, and actually what makes me think of this is, you know, when Ralph Sapkota tried to do the Harvard Group scale in Nepal with kids who had had possession experiences and he didn't call it hypnosis because that didn't mean very much. He was just, this is a test of your concentration and your imagination. As soon as you started the scale, some of these kids who had possession experiences fell before it had a possession. So that kind of fits with your thing that it's all of a domain in their mind somehow even though he wouldn't imply that. And then making some connection in there, having this more profound dissociative response that sort of looks like that. So that should be, and that was a measurement called, impractically he couldn't have been through the scale to the people who probably would have scored highs on the scale how they had to go through all that. You could flag those people who have the amnesia experience and further exploration of some kind. I mean I suppose the scale also in a way in the structure of it assumes that amnesia is suggested because so the suggestion is that you will forget the experiences until there's a certain queue at which point you'll remember the experiences again. So it's actually when you're reporting there's kind of two phases.  But I think yeah, that one's quite rare. That's quite a difficult item to pass. Most people don't. So this is just kind of a fun demo of I mean how many people are familiar with the McGurk effect? Not so many. Okay so this is basically another way without relying on kind of the complicated questions about neuroimaging, reverse inference and so on to see whether we can override effect that are quite automatic in our perception using suggestions. So this is the McGurk effect which I'll show you. So basically I'll play this video and if you just look at the speaker and listen and just pay attention to what you're hearing. Ba ba, ba ba, ba ba. So what was, did anyone wanna volunteer what they heard? No. Yeah so most people will hear something like da, da. Now if you watch it again but close your eyes. Ba ba, ba ba, ba ba. Yeah so I don't know how many people. That's the same video. So basically what's happening is that there's this kind of auditory visual integration that's happening in speech processing at a very low level, very quick in the cognitive hierarchy where basically what you're seeing is interfering with what you're hearing and so the video is actually dubbed with a sound that doesn't match what you're seeing them mouthing and so the video of them mouthing something like ga or da actually automatically interacts with what you're hearing and it changes your auditory percept. So what we can do is give people a suggestion where their hearing will become like super hearing, like a hunting animal and they'll be able to very clearly discern what they're hearing and what we find is that for highly suggestible people this dramatically reduces the auditory illusions that they experience so this is a way of showing that only for these special, this kind of highly suggestible segment of the population this kind of quick verbal suggestion can dramatically alter low level processing in the perceptual system of the brain. That normally you wouldn't really be able to fake this because it's a behavioral index that it's a performance measure. So you can try but you're not gonna be able to figure this out normally. So yeah, so what's interesting about suggestions? So you might think about like suggestions in the science of hypnosis are usually like these kind of quick verbal suggestions like you are going to experience this or your perception is going to change in this particular way. So it's interesting to think about how that's different from just giving someone an instruction to do something and what's been discussed a lot in the literature it's called the classic suggestion effect is that when you carry out a suggestion it should feel like it's happening of its own accord. So it shouldn't feel effortful. It's like your perception is changing but you're not doing anything actively to make it change. And that's kind of one important distinction between or maybe the key distinction between instructing someone to have an experience or to do something with their mind versus suggesting to them that something is gonna happen involuntarily to them. So there's like a very complicated, there's a lot of different theories about how suggestion works and how hypnosis works. One of the I think most kind of promising avenues of thought has to do with something about our sense of agency. So normally when we perform an action like let's take the example of just the hand levitating which is like a classic hypnotic experience. So clearly the hand is levitating because somehow the body and the brain are sending a motor command to levitate the hand but there's something about the suggestion experience or the hypnotic experience where the awareness that one is sending that motor command is somehow dissociated. So you're not monitoring your own volition somehow.  So people have kind of cashed this out in a lot of different ways but in general there's this thinking that hypnosis and suggestion has something to do with our ability to dissociate our action planning from our monitoring of those action sequences. So this is kind of an interesting study that came out a year or two ago showing, so basically this is a task where your job is just to, it's kind of like these are falling shapes and your job is just to catch the X's and avoid the O's. You're just like using a cursor on the screen and then you modulate the lag. So you introduce a lag so that as you're moving the cursor there's like this little annoying lag where you're not quite in control of it. And then you ask people to judge how much agency they had over the game. So you can see that highly suggestible people and less suggestible people have basically the same performance and they're all able to monitor their performance comparably but when it comes to monitoring how much agency they had over the experience or over the cursor highly suggestible people have a specific deficit where they're not as accurate. They're less able to monitor their own sense of agency. So this seems like this is kind of pointing to something about again this idea that somehow you can be the agent or you have some kind of dissociation where you're not as meta aware of your own intentionality and that's maybe what allows for these experiences of a hand levitating out of your control. And we also, I think there's good reason to think that this might also account for things like possession experiences and so on but that's kind of an open question that we're starting to explore now actually. So this idea of kind of modulations in the sense of agency have been really central to the science of hypnosis. It's still not really clear why the ability to dissociate your awareness of your own agency would allow you to modulate really like fundamental features of your perception. Like, okay, so I don't feel like I'm the agent of my actions. Why does that let me do things like see a colored picture in black and white or override the McGurk effect? So that's still kind of an, you know, I think that's kind of where the field needs to move is to understand how this phenomenological feature or this kind of higher order control dissociation allows people to modulate low level perceptual processes if that makes sense. And I don't think there's really a good answer for that right now. Another thing that kind of comes up a lot in the science of hypnosis which relates to what we heard about earlier today is this idea of the imagination. So, or mental imagery or kind of conjuring representations in your mind's eye. So this is actually quite controversial. So a lot of hypnotic suggestions involve imagery or like sometimes implicit imagery but sometimes quite explicit.   And it's controversial because for a long time people thought that this was really central to what's happening and how hypnosis works but then there's been some debate around that because it turns out that even if you tell people to imagine, if you give someone a suggestion but you tell them to imagine the opposite so you might tell them that their hand is rising involuntarily but you ask them to imagine that their hand isn't. You can actually still show suggestion effects when they're imagining the opposite experience. So people have used that to argue that imagery might not be as central a mechanism as we think. I put this slide up because we did a meta analysis of all of the neuroimaging studies of hypnosis and so it's a bit of a messy thing to do because basically what you ask is you look at all of the fMRI studies that have shown a difference between responding to a hypnotic suggestion and doing the same thing without a hypnotic suggestion. So these are like all kinds of different suggestions, all kinds of different tasks and you lump them all together and you ask is there something that transcends all these differences? Is there something about just hypnotic suggestion overall that's consistent across these studies statistically? So it's quite a messy conceptual thing to do but what we found which is maybe of some interest is that the only significant cluster that's popping out across these different studies is in the lingual gyrus which is this kind of, it's kind of a higher order occipital region so involved in visual processing but especially it's been involved in mental imagery processes as well as many other things but so and then if you go back and you see the studies that actually contributed to this cluster what's interesting is that most of them didn't involve an explicit suggestion for imagery so it'll be a suggestion for something else that doesn't actually involve imagery per se and then it seems like people might be, people seem to be using this area that's been implicated in mental imagery to respond to those suggestions but I mean this is like a real reverse inference like we don't have, we'd need to have some better phenomenological data to look into whether people do use imagery as a way of, as a kind of strategy for responding to suggestions and we know also that there's like people, there's heterogeneity in terms of how people respond to suggestions so some people like there's been discussion of a dissociative subtype that when they hear a suggestion they dissociate and they are more prone to amnesia and so on and then there's other subtypes who respond to the same suggestions but in different ways even though they might show the same behavioral effect so there's this kind of important question of like maybe some people use imagery and some people don't in responding to suggestion. Lawrence, do you have a? Well I just think this is an old study like Kent Bowers I think around pain control doing a morphological kind of briefing and finding exactly that that some people said oh yeah I was imagining being on the beach or something I was doing something that competed with the pain and other people said no it's just nothing going on or I just slurs off the pain somehow. Right, yeah. Okay so yeah so it's interesting so one of the kind of classic ideas and it's been a massive and it's kind of still an ongoing debate in the field of hypnosis especially if you're uninitiated into the field people usually have this idea that there's like a special state of hypnosis so there's what's been called like the state non-state debate or kind of socio-cognitive theorists versus state theorists and basically the idea is that there's this ritual the hypnotic induction which has certain kind of structural features so like I said before usually you'll tell someone okay now I'm gonna bring you into state of hypnosis your eyes are feeling heavy, you're getting sleepy, your attention is very absorbed you know like focus on my voice just go along with my voice so there's a few features normally we think of like relaxation, we think of attentional absorption and also this idea of a yes set so that you start with easy suggestions that are very kind of natural to follow along with like your eyes are getting heavy and maybe eventually you might find your eyes closing and so this is really easy to kind of go along with and then once you're in the habit of responding positively to suggestions then you start to introduce more difficult suggestions and so that induction ritual some people argued for a long time and still do that there's something very special about that set of instructions that there's something important about having your attention absorbed and about being relaxed that allows you to then respond more strongly to suggestions, other people argue actually there's really nothing special about relaxation for instance and there's been studies showing that if you have someone like vigorously peddling on a stationary bike, you can still hypnotize them and they can still respond strongly to suggestions so they don't have to be relaxed to be to respond just as strongly so there's some controversy over relaxation then attention also there just haven't really been that the thrust of the literature suggests that the specifics of the induction procedure don't actually make that much of a difference in terms of how you're gonna respond to suggestions after so at this point I would say the overall what we tend to see is that like 80% of the response that's kind of an estimate and it depends on the specific suggestion but you can get about like 80% of the suggestion response even if you skip the induction procedure entirely so like some of the most striking effects that we see with hypnosis you can reproduce them with a highly suggestible person by just giving them the suggestion cold with no induction, no relaxation, no absorption and so on some people argue that that's just because those people are so prone to hypnosis to the special state that they just naturally slip into hypnosis as soon as you give them any suggestion they spontaneously hypnotize themselves but that's kind of been a complicated position to uphold empirically because it's kind of hard if you just say that at any time you give someone a suggestion they naturally slip into a state of hypnosis then it becomes very hard to dissociate those two things. I mean so clearly if you give someone a set of suggestions or instructions that correspond to a classic hypnotic induction you do see changes in their brain you do see like a specific set of phenomenology like more relaxation, more focused attention and so on but the key is does that specific phenomenological state actually or cognitive state actually enhance response to suggestion and it seems like in most cases that it might a little bit but that doesn't seem to be the key variable. What's also interesting is that some people have argued that yes it does enhance response to suggestion to some extent but that's just because it's a suggestion in our culture we associate hypnosis with the idea that we're gonna become responsive to suggestion so this was a study that basically used the exact same hypnotic procedure but in one condition they called it hypnosis and in another condition they called it something else I don't remember off the top of my head maybe like something like creative imagination or some kind of relaxation procedure and they found that just calling the exact same procedure hypnosis actually increases people's suggestibility after that procedure so there's something about just the cultural narrative around hypnosis that is part of what's going on here and part of why the induction works to some extent but so this kind of whole idea that actually the bulk of the variance in these effects is coming from the suggestion it's coming from the suggestion itself and the suggestibility of the individual not a special state of hypnosis so a lot of the field has kind of shifted towards the broader domain of suggestion so just thinking about how without any specific hypnotic context suggestions might be affecting us all the time in our daily lives or in all kinds of contexts that normally we wouldn't think about how kind of the concepts or the words that we're receiving are actually influencing the way that we experience the situation so this kind of relates to placebo effects just one quick question as well that made me think of almost like the adaptiveness of this ability for social coordination I'm just curious, there are these studies by Ziggaladis and others about synchrony and various physiological kinds of responses during like fire walking or other kinds of rituals I'm curious is that, does that, which you could imagine that that could be following suggestion type principles possibly is there any attempt to connect this literature with larger literatures of social coordination and that's basically what Sam will be talking about oh okay, okay great. So I mean just to say like maybe you could also think about suggestions as encompassing more than just verbal suggestions so like cues in the environment, you know a white lab code and needle is gonna help me of placebo pill and so on so maybe with that I'll pass it over to Sam. Oh thanks. So what I'm gonna try to do is first bring things back in like a more general anthropological and philosophical lens and then later on we'll get to talk hopefully I'll get to probably not answer your question Jeff but maybe pose it in a sort of a precise way cause in a few moments we'll be talking about topomancy, you know the new subculture of people who conjure imaginary friends and I'm often solicited to talk about topomancy but really the part of that study that I did that really lies closer to my heart is this notion of hypnotic sociality that I developed that I think not many people like or understand but this idea that being social, being cultural routinely recruits the kind of processes that you might call hypnosis. So I am also perhaps more so than you Michael I'm of the sociocognitivist camp in trying to understand hypnosis I'm a big deflationist about the importance of the induction ritual and I say this as someone who trained in clinical hypnosis who uses clinical hypnosis in the lab who likes to work on different induction rituals but very much like Nicholas Spanos' idea that the induction ritual is just a culturally situated practice that may enable us to reach some kinds of processes that are routinely recruited in lots of other ways. So again to recap what's hypnosis I'm really not sure but I think it has some kind of a process that modulates or that targets or that harnesses automatic processes so things like autonomic, limbic, subcortical processes that we typically cannot access volitionally so things that we just can't will into experience things that sort of happen to us. You may know Mikey that I'm also a little bit of a Jamesian in the sense of I often think about Bruno Snell and William James who are people who made the rather provocative claim that the sense of agency the sense of self even or even the practice of attributing our own inner speech to the self may be a rather recent cultural invention and I think there are many philosophical traditions that talk about the illusion of agency how agency might be an illusion. So hypnosis might also be whatever kind of culturally situated practice that enables us to bypass this sort of inefficient delusion that we are the authors of our own actions. So when we think of the classic Libé experiment for example, the idea of readiness potential and Michael you probably know the timescale better than I do but one can detect and record activity in the premotor cortex is it over a second? I think they add up to six or eight seconds. Up to six or eight seconds before the intention to move to initiate motor movement is registered in consciousness. So I wanted to make this movement. I'm speaking with my hands right now but maybe something was happening in my motor cortex up to six seconds ago, deciding that this was going to happen. But for sure things are not that simple and we may return there. An idea that I think about a lot recently is something that my monody said which is that that which we think is voluntary is in fact involuntary that which we think is involuntary is in fact voluntary. So we often tend to be very confused about our own agency. So we may momentarily cast aside those big questions about whether or not we're always on some sort of autopilot and whether hypnosis may just be the baseline mode of functioning. Let's cast these big questions aside and let's talk a little bit more specifically, mechanistically about different automatic modulations of attention. And so I'll be transitioning to talk more about placebo effects which following the works of Amir Raz and Michael Liftschitz may be an interesting way to think about those kinds of modulations of automatic processes. So we often tend to think of placebos in popular culture as an inert pill that produces medical effects but perhaps a more interesting way to think about it is what has been turned into non-specific effects. So the healing responses that cannot be attributed to say a chemical substance itself or like the intended mechanism of the treatment but people still sort of get better. So here, yes, I'm quoting the works of Ted Capchak who's at the Harvard placebo program at the placebo program at Harvard who talks about placebos as basically a combination of psychosocial, verbal, symbolic, interactive and ritual cues that again modulate our harness, expectations and self-healing. So the context of course is very important and I talked a little bit about our experiments here in the RAS lab in attempting to produce and curate a context in which people will expect and expect to heal. So things like decor, things like clinical costumes, things like the charisma, the reassuring tone of the physician. These have all been to some extent measured as being causally significant in inducing healing or not. I'm gonna keep pointing your attention towards the interpersonal and sort of the social and the relational context of these processes that again modulate automaticity. So it's also been noted that for example, when patients can observe improvement in other patients then lo and behold, they will tend to improve as well. So what are the kinds of effects can we talk about? Yeah, so the caller, Michael will talk a little bit about this but there are some effects that may be perhaps more or less culturally situated like blue pills, blue placebo pills tend to induce more calming, more soothing kind of behavior whereas red pills are more sort of excitable. Although apparently there's a few, I'm aware of at least one study showing that in Italy because people tend to associate the color blue with the football uniform then it tends to trigger different kind of arousal so blue pills are not soothing for Italians. Something that's also interesting and so the more invasive, the more costly, the more motivationally costly a procedure, the better it will work. So in a placebo treatment two pills will work better than one pill or like a heavy big gel cap that's difficult to swallow will work better than just a small pill. A sham injection will tend to work better than pills and then sham surgery will tend to work better than injection so there are experiments particularly in chronic pain and low back pain reduction where having people undergo the ritual of waiting for surgery, talking to a surgeon, expecting to heal, being put under general anesthesia, having their back opened up and stitched and awakening and being told that things went very well while that apparently works quite well for some people for chronic low back pain. So more and more we're beginning to understand that the more sophisticated the procedure, the better it works. What are some kinds of conditions for which suggestion or placebo or nonspecific effects are known to work very well? Depression is one of them in a moment I'll talk a bit about the controversy about placebo effects in clinical trials and SSRI's medication, anxiety, irritable bowel syndrome, so back pain, pain in general, migraines, chronic fatigue, allergic rhinitis, ADHD. The little asterisks this refers to recent studies in clinical trials using a very interesting open label placebo procedure. So this is a procedure in which patients are told without deception that they're taking a placebo that other people have also gotten better with this placebo and then the effects are also quite high. So there's different iterations of this paradigm. Sometimes the open label condition is revealed post hoc. So they're also studied on placebo conditioning. We'll say people are used to associating a particular ritual, a particular treatment with getting better. Later on they're told actually what you were taking was a placebo and the symptom alleviation tend to persist even. Now something that Amir, Michael, Jay Olson and I are thinking about is that in the sort of hype about the ethical promise of the open label paradigm it may also be that there's something about the social context that is still not very well understood. And I spoke a little bit when I presented our experiments in placebo treatment at the strange finding that people no matter how many times they're briefed on the condition they seem to forget that it's a placebo. Perhaps because the cues are so well curated that they revert back to kind of an automatic schema. So I've talked about this a little bit, the individual differences, because the question is also what kinds of people are more likely, not just what kinds of conditions or what kinds of experiences, but what kinds of people are more likely to be responsive to suggestion and placebos. So Mikey talked a bit about the individual differences, about measuring suggestibility, whether it is a stable personality trait. I think you said that it tends to be stable over time. Isn't there also findings showing that children, on average, tend to be a bit more suggestible so between the ages of... It's a bit more adulthood, yeah. Yeah, in adulthood. And I know it's controversial, but I'm aware of some studies showing that women, on average, are a little more suggestible than men. I don't know why half of that sentence is in French. Which really would make sense to me as for a socio-cognitive model of hypnosis. If we also accept the finding that, on average, women tend to be better than men at social cognition. They tend to be more responsive to social cues. They tend to experience psychosocial stress and socially-induced negative affect more. We also found, I don't have a slide for this, recently, that smartphone addiction and smartphone overuse also correlates with hypnotic suggestibility quite strongly and that fits quite nicely with one of our hypotheses that I talked about already, that smartphone overuse has something to do with hyposocial tendency with responsiveness to social cues. And we also found that, on average, females are more prone to smartphone addiction. We don't have a whole lot of time to get into this. Often people get really interested in the ethical question about placebo therapeutics and using suggestions for treatment because we do find that there are many, many kinds of automatic processes and healing processes that happen with suggestion procedures. I think it's also important to try to parse out those aspects of human experience and of human distress in particular that are amenable to suggestion interventions and those that are less so. So I often like to say, well, you know, a placebo is not gonna cure a tumor or cancer but it may help improve some different dimensions of the illness experience, like hope. So there are studies, for example, in oncology treatment of placebo, open-labeled placebo treatment, improving appetite, reducing fatigue, improving quality of life in general. And there probably is quite some promise about the kinds of chronic conditions that still elude our best nosological understanding and that still are not very responsive to treatment. So briefly, as an example, some of you may be aware of the ongoing controversy about the efficacy of SSRI medication. So I'm not gonna go into other controversies about adverse effects of SSRIs but Irvin Kirch, who's also at the Harvard program in placebo studies quite some time ago now under the Freedom of Information Act, accessed a lot of data from clinical trials and he found or at least claimed to have found that in most cases, there was really not much of a difference between the placebo arms and then the medication arms. So in other words, if SSRIs had an effect over placebo, that effect was marginal. I think it's important to point out that subsequently it's been found in several studies that SSRIs do have an effect for people who suffer from severe depression as opposed to mild or moderate depression. But even then, some people like Joanna Monkreath and others in the critical psychiatry movement have made the argument that those effects, the improvement that we find even in clinical trial or in clinical practice of people taking SSRIs may be largely attributable to placebo rather than or no specific effects rather than the chemical properties of the drug. So briefly, this study, when is it from? I think 2017, it's one of my favorite studies. It's very elegant, very well-designed in Sweden. This is a study in which verbal suggestion is shown to influence both the clinical outcomes and the neural dimensions of acetalopram treatment for social anxiety disorder. So acetalopram is an SSRI. So the study of the design was really clever. It was a randomized controlled trial in which both groups received standard dose, I think 20 milligrams of the medication over nine weeks, but one group, the overt group, was given accurate information about the treatment, including some hope that they may improve.  The other group was told that they were taking an active placebo from which no improvement could be expected. So the experimental group was basically a no-cebo condition where they were told, well, no, this is not gonna work, but we're just testing this active placebo for further clinical trials. I don't have the slides here, but the effect size was really huge. So people in the overt group were given accurate information plus hope on the treatment, had something like three times better symptom improvement over the course of the trial, basically twice the effect size. And there were also some different brain findings in an emotion face recognition task or something. I forget the exact results, but even, you know, new early there were some interesting results. So this goes to show, again, just the importance of, well, as a verbal suggestion, but also the whole interpersonal and social context in which people's expectations are modulated. So I won't go into this very much now, but if you're interested, you can look at the World Medical Association declaration of ethical principles for medical research where increasingly it is being recognized that placebos when introduced judiciously bear significant promise for the treatment of some conditions, including chronic conditions. So this is it for my part on the non-specific mechanisms, but I hope to jump back in later to ask again the big questions about the ways in which we may routinely, yes. So I wanted to ask you a question, which is my understanding of the Cure's work, it was qualified in a way that you qualified it with. There's less of a placebo effect for severe depression. That's right. That's right. And then you said there's something else by Dema, who's Dema? Monkri, Joanna, she wrote a book called The Myth of the Chemical Cure. She published a few articles in her journal. I think she's interested in- You said it was not, even among the severe depression that could be shown as being placebo-driven, but my understanding was that, precisely when you divide it out, the kind of placebo contribution to versus SSRIs in the mild and moderate versus the severe groups, then you saw quite a difference where in the severe group, there was quite a difference between the placebo group and the effect of the SSRI. Yeah, so there is, and it's always really difficult to attribute this to specific or nonspecific effects. The kind of study that I think we need are the ones that I just presented, but imagine the one that I just presented with maybe two more arms. So in two more arms, it's placebo only, but in one condition they're being told this is the real treatment, and then in the other ones they're being told it's a nocebo, and then you could even introduce another condition where people are given really, really high hopes where people are told, well, 99% of people reach total remission with this. And then comparing the results with broad enough sample size, we may be able to better answer those questions. It's Joanna Monkreef. Joanna Monkreef, yeah. Okay, so now we're gonna kind of start to transition towards meditation and try and think about how some of these mechanisms might also be at play. So this is just to kind of remind you that different types of placebos might have different effects. So then if we think about something, I mean, this is kind of an interesting 2018, 2019 version of meditation, but if we think of something like Muse, the brain sensing headband, which is a $300 headband, which basically is a kind of consumer grade neurofeedback device that reads your brain waves and gives you feedback on how active your mind is or how well you're meditating so that if your mind is very busy and chattery, then you'll hear, I think you'll hear some kind of like stormy sound or like crashing waves. And then the more quiet that your mind becomes, the more peaceful that the soundscape becomes until you're kind of hearing birds. And that's when you know you're meditating very well. So this we might think of in a way as a kind of super placebo. If we, so we know that this actually works. So if you use a Muse brain sensing headband, it actually does lead to some benefits in terms of attention and potentially like some affective regulation, but it's unclear why exactly that is. So you might think that it's because of the brain feedback that you're getting, but there might also be a sense in which there's something about the fact of putting on this fancy equipment, paying $300 and sitting with this thing on your head that might actually bolster the suggestion that you're going to be improving your attention. So there's actually like a pretty vast literature on neurofeedback and using these kinds of brain feedback interventions for clinical conditions as well. And some of my colleagues and I have done big systematic reviews of this literature. And what we find is that most of the studies, actually the situation is getting better, but up until quite recently, most of the studies really weren't very well controlled so that although you were seeing improvements in the neurofeedback arm, you didn't really have an adequate control group where you would use some kind of sham neurofeedback, like where you get the same kind of fancy equipment and everything, but not veritical neurofeedback, which would actually allow you to tease apart whether what's actually making the difference. So to clarify, so like this is an example of a study that we were commenting on where basically it was people with insomnia and they were going through this EEG neurofeedback scenario, but one of the groups was getting sham neurofeedback. So they were getting brain feedback, but from a frequency in the brain that there's no reason why they would think why it would be related to their insomnia. It was actually just kind of a scrambled random brain signal. And what they found was that so people who got the genuine neurofeedback, they were able to regulate their brain state whereas the people who got sham feedback couldn't regulate their brain, obviously. Both of the groups, in both of the groups, the patients reported a subjective improvement where their sleep quality was better, but when it came to actual objective sleep quality measured by polysomnograms, there was actually no difference in either group.  And so it kind of caused a splash when this kind of started coming out because there's a whole industry of neurofeedback, like there's a lot of money invested in this, there's a lot of people whose entire careers are invested in this, and who are seeing these benefits in their patients who think that the benefit is coming from the feedback, but actually it might be something about the whole context of the intervention. I should say though that with more, now there's some good trials coming out, some good randomized controlled trials with good sham controls, and especially with kind of fMRI neurofeedback or more, like there's some kind of pattern classification based feedback that's a little bit more complex than just thinking that there's this one signal in the brain that's gonna help you sleep better. And those interventions seem to have a little bit more of a specific effect of the brain feedback. So it's not that we're saying that neurofeedback doesn't work at all, or that it's all a placebo effect, but it's just to point out that a lot of the power of this intervention might be coming from the social factors that normally people have thought of as kind of noise or something that doesn't matter. So no intermission. So now if you think about meditation, right, so this is kind of, you know, there's been a lot of different ways that the mechanisms of meditation have been contextualized or theorized, but this is kind of like one of the dominant general frameworks for thinking about how meditation works. So basically there's some kind of set of brain networks and you're iteratively training those networks to function more efficiently. So maybe you're mind wandering, there's this default mode network that's activated, then you become very skillful at noticing when you're distracted at reorienting and then sustaining that focus and this is a kind of, so it's a kind of brain training where you're a person learning to do this specific thing and that's what allows you to then attend non-judgmentally in the present moment and then that's what's causing clinical benefits. So this is another paper that kind of, it was in 2011 and this has been really one of the most influential mechanistic papers, like a review paper, it's been cited almost 2,000 times and these are kind of the mechanisms that they propose. So attention regulation, awareness of the body, reappraisal, exposure to emotions, extinction, reconciliation, changing perspectives on the self. But so all of these mechanisms, I think that all of these mechanisms are very important in meditation for sure, but what's missing here is some kind of social picture that there's anything about the kind of worldview that you have or your expectations of what you're doing, the people you're around, even the way you're situating your body socially, that that's completely missing from this picture. So then there's been this kind of what you might think of as like a contextual turn or a cultural turn in the science of meditation in the last few years that has started to really emphasize the fact that basically these practices are not just an individual brain, like a loan in a room regulating itself, but that they're always culturally embedded and that the context, the social context might actually have a constitutive effect on the outcomes of the practice or on what the practice is like. So for instance, David McMahon, who is the editor of this book, which is really an excellent book for kind of bringing together social scientists and humanity scholars to think about this intersection between Buddhism and science. And he gives an example of, if you're a monk like in, I forget where, but basically a Southeast Asian monk in Southeast Asia who's basically trying to transcend the wheel of birth and death and has been kind of removed from their family for many years that probably the way what happens in the moment of mind wandering during a meditation practice is gonna be very different for that monk than for someone who's taking a 10 minute break from their day before going to like their business meeting or something in New York. And that the way that the mind wanders and the way that one is thinking about like the meaning of that mind wandering and what it means to bring the mind back and that all of these, that there's all kinds of kind of situated dynamics that are actually going on in the phenomenology of the actual meditation session that are gonna have an impact on what you get out of that meditation. So, I mean, this is like a really complicated thing to think about the situatedness of meditation. It's not that there's one thing going on, but I think one interesting place to start that relates to kind of the science of suggestion and hypnosis and so on is how just basic expectancies might be affecting what's going on in meditation. So this is just a study that kind of showed this quite elegantly. It was a short-term meditation, so novices who had never really meditated before and they were just introduced to meditation and told to do like a very simple breath awareness exercise like a kind of mindfulness practice. And in one condition, sort of with half of the subjects, they told people that meditation improves your attention capacity and that after the meditation you're probably gonna have kind of enhanced attentional abilities. In the other group, they said that because you're meditating, you're gonna kind of exhaust your mental resources and you're gonna have worse attentional performance and they found that the effects on like these attention tasks were completely opposite in these two groups. So even though they did the exact same practice, the outcome was different. Now, obviously this is kind of like a microcosm.  So if we can see these effects in the short-term, to me it makes sense that similar kinds of expectation mechanisms might be in play in long-term meditative training. So I did like a lit review of there's not too much, but there are some studies looking at the relationship between expectation and meditation. So there's a few studies showing that if you tell people that meditation will increase their attention or affect their physiology, that you actually see modulations in their physiology or attention. A lot of these studies were like from the 80s. Highly suggestible people do seem to respond more strongly to certain kinds of meditation. Initial expectations might be related to how much you actually sustain your practice in the long-term. And yeah, there's actually been some studies showing that without giving any instruction of meditation, but just telling someone to sit quietly and calling it meditation, you can get some of the same effects as actually giving a specific meditation instruction. But again, I really don't want this to be some kind of deflationary account because I don't think it's the case that meditation is just suggestion or just placebo, but I think it's interesting to consider the possibility that part of what's going on in these practices is that you have a specific idea about the outcome and that that might actually help you regulate your mind in a way that aligns with the outcome that you're hoping to cultivate in yourself. So I think that we know also from placebo studies with a placebo pill that the placebo, the kind of placebo mechanisms can actually interact with the constitution of the gut in that moment to actually synergistically create a different effect. So it's not that there's nothing going on chemically in terms of the actual molecule of the drug, but that there's something about your ideas that actually can let's say make your gut more responsive to the drug in a particular way. So there might be something similar going on where there is a training of attention that matters, but there might be something about holding a particular attitude or expectation that can actually facilitate that training effect. Mikey, may I briefly interject about something we might have a chance to talk about later, just in trying to historicize these studies without knowing much about the conditions in which say no differences were found or meditation was found to be more effective. If you look at the first studies in the 1980s and 90s, when culturally at the level of everyday intuitions that people might have, meditation was probably much weirder, much more of a counterintuitive thing that people would approach tentatively. Whereas nowadays in some circle, it's almost morally obligatory to meditate, which I'm not just talking about confirmation bias, but it's just not surprising to me historically that more and more studies are going to find these benefits to meditation because of the cultural movement that we're in. Yeah. So I mean, this is just to say mindfulness based therapy is like a massive industry now. It's been shown to be very effective in the treatment of certain conditions, like specifically in depression. It's been really kind of a somewhat of a, like a small revolution in the treatment of depression. And I mean, this is just kind of to say that different kinds of meditation are associated with different specific kind of functional alterations in the brain, as you would expect. Yeah, I mean, this is just to show, this is just some data that we recently published showing that mindfulness therapy for some chronically depressed patients really improves their depression symptoms, compared to a relaxation control group. And that we could find specific functional connectivity changes in the brain that were also brought about specifically by meditation rather than the control group where they were basically not meditating, but taking time out of their day and told that just relaxing could help them. So this is another way of saying that there is something specific about meditation and the way it impacts brain function and the specific effects we found were related to the dorsolateral prefrontal cortex, which is a region that's very important in attention regulation. But again, even here, even with a control group like this, we haven't controlled for the fact that one of the conditions is called mindfulness-based therapy and that that comes with a host of associations and kind of symbolic cues of how much we might expect to feel better. This is, I guess, you know, this is maybe the most solid brain imaging study of meditation that's been done. It was done by Tanya Singer's group. She was in Leipzig at the Max Planck Institute and they looked at the effects of three different kinds of meditation in a large sample, like 80 people per group. And they tracked meditation practice over nine months so they could actually see longitudinal changes in behavior, in brain structure, and in brain activity that were associated with these specific practices. So they had a kind of a presence module where you learned basically attention and this kind of bare sense of awareness of your body and your mind. And that was associated with, you know, particular of these kind of yellow regions are the parts of the brain that became, the parts of the cortex that became thicker in response to those practices, which are kind of attention regions. And then you had an affect module which was about compassion and relating to other people and being more in touch with one's emotions. And there you see kind of this empathy network and more social cognitive networks being strengthened. And then there was this perspective module which was more about kind of becoming more aware of the patterning of your experience and kind of deconstructing the mental structures that we normally take for granted, basically. So kind of what is the self, what, you know, and kind of analytically thinking about what and who we are. And that was associated with these, you know, another set of regions. But basically the idea here is just, they also found nice correlations between the specific brain network structural changes and actual behavioral changes in terms of how people performed on theory of mind tasks or attention tasks. So this is just to say that there are kind of specific effects of these different practices. Also, yeah, there's this kind of question about the different phenomenological dimensions of practice. So this is, they did very thorough phenomenological interviews with participants as they were going through these different meditation exercises and they find, so here they're mapping like which parts of the body felt more active in these different practices and also which colors were reported as being kind of associated with the experiences, which is kind of interesting to think that there might actually be some kind of systematic relationship between colors and different practices or phenomenology. And what's interesting here is that the interviews were rather non-directive, so it was quite open and people just tended to cluster around certain colors. For instance, these kind of warmer colors for the loving kindness meditation, which is interesting and potentially culturally mediated as well. I'm wondering, yeah, okay, so another thing that's kind of interesting to think about in the field of meditation is that it's tended to focus on a very limited subset of practices. So like I said, I mean there's been this kind of mindfulness revolution, some have called it, or this kind of trend of mindfulness in contemporary culture and a lot of that, I think comes from mindfulness-based therapies, which have been quite successful clinically. So until recently, the field of meditation was really focused on mindfulness practices, this kind of practice of becoming aware of your experience, reorienting your attention on some kind of attentional, like an object, like the breath, and then learning to regulate your attention, so it was really framed in terms of attention regulation. And now, more and more, the field is opening to other practices, because if you look at the tradition of Buddhism, for instance, which is like a massive, multi-millennial tradition that's scattered around different parts of Asia and has all kinds of different practices embedded in it, you see lots of different kinds of meditation. Meditation is not just this kind of mindfulness practice. So one really kind of, a lot of energy has gone now into thinking about compassion-based practices and social affective practices. But this was a recent paper in one of the biggest journals in the field of cognitive science, opening up the domain to think about all of these different types of practices that we might consider as part of the field of meditation. So here, focused attention practices are just one small square, and then you have practices about having different relationships, like having moral vows that you have or cultivating compassion, but also visualization practices, meditating on the foulness of the body and so on. And so one kind of simple way of dividing this up is to think about apophatic practices, which are practices that emphasize more a kind of emptying of the mind or a kind of simplifying of experience, and then practices that are more about cultivating something or constructing something. So if you go back here, you see that there's this kind of attentional family, which is about regulating one's attention, and then there's a constructive family, which is more about building new values or new perspectives and kind of maybe automatizing certain mental qualities that we think are beneficial. Then the deconstructive family is this kind of more analytic collection of practices where you're actually looking into experience and kind of trying to deconstruct it to see how it's patterned in a way that might give you some insight into your own experience. So, I mean, Tanya talked a lot about this this morning, so I'll just go through it really quickly, but basically there's this whole kind of collection of practices that has been very little studied on visualization, cultivating the imagination. So there's like one study showing that practitioners of deity yoga in the Tibetan Buddhist tradition have in the moments right after they practice these kind of elaborate visualizations, they actually have quite enhanced visual spatial processing resources in their brain, but basically there really hasn't been much. There's Tanya's study looking at how mental imagery training in the context of Christian prayer actually can improve people's mental imagery skills and also their capacity to experience imagined others like Jesus or like God as a kind of person that is subjectively real for them. So we are actually now in the process of trying to get some sense of the neural correlates of these kinds of practices. So this is one of our subjects, Siobhan who is someone who is in a neo-Pentecostal church in San Francisco and she is a very, she's very in tune with God. She's someone who hears a lot from God, who feels the Holy Spirit coming into her body quite regularly. So on this day, this was the first day that we brought her in for an MRI scan where we're basically trying to capture experiences where she's praying, but then she has the experience that there's another agent like God or like the Holy Spirit who comes into her subjective space and has a sense of presence in her own mind. So when she came in, she was telling us that that morning she was feeling lots of presence and actually the first time we put her in the scanner, she told us that she got like several prophecies and that it was quite a striking that she was really getting the strong sense of a presence and even like specific thoughts and visions that were coming to her from God. And so basically we're trying to see if we can find specific circuits in the brain that might be shifting to allow for this experience of another agent entering into one subjective space, even though that agent is immaterial and can't be seen or touched. So, and so this is your brain on God. No, but so we only have one subject so far, but actually it's quite nice. So what we're really interested in is the idea of agency. So again, this kind of ties back into hypnosis where again this kind of fundamental effect is that the suggestion feels like it's not your own volitional choice. So similarly in a lot of these religious encounters, you have the experience that you have either a thought like a prophecy that comes to you or it could even just be something as simple as this is the shirt that you should wear today. But the idea is that that thought in your mind does not feel like yours. It feels like there's another agent that you might even, for some of these people, they even hear it in their own voice, in their own internal voice, but there's something about the quality of the experience that makes it feel like it's not them. And so that feeling of not me-ness or an agency modulation is what we're trying to capture here. So there's also related, so basically there's like a theory that thought, inner speech, like we know, we're always thinking all the time, or not all the time, but there's studies showing that like more than half of our daily lives is occupied with discursive inner dialogues for some of us. So the idea is how does that internal dialogue sometimes experienced as not belonging to oneself or as coming from someone else? And what's related to that is also in, so for these people in these neo-Pentecostal traditions, there's often this experience of speaking in tongues where basically the body becomes infused with another presence, so the Holy Spirit, who then takes over the movements of the tongue and starts speaking through the person. So again, there's this kind of modulation where there's a kind of speech that doesn't feel like one's own speech. And so this is, what we see here is actually kind of nice. It aligns with some of our hypotheses that this is in the pre-motor area in the brain, which is an area that's involved in kind of intention planning. It's the area where from activity in this region, you can decode up to eight seconds in advance which button someone is gonna push even before they know which button they're gonna push. So there's something about kind of motor planning and intention that gets coded in these pre-supplementary motor areas. I mean, the motor system is quite complicated, but this is definitely an area that, for instance, you can perturb it with TMS, trans-cranial magnetic stimulation, and that will actually alter someone's sense of agency over their own actions. And so we were specifically expecting that there would be a deactivation in this area in conditions where people are having an inner dialogue, but they feel like it's not their own, and that's exactly what we see from this one subject. So that's a little bit encouraging, but we'll have to see what we find with more data. Jeff has a question. I have a question. So there is this older literature on the God spot of the brain. I was just kind of refreshing my memory of it a little bit. And I remember it as like the ripe, bridal, low, and I think they're more interested in like mystical experiences of loss of boundaries of self, for example. But I'm just curious, is there anything salvageable in that older research, or is that informing any of this, or, because this goes back, I mean, even maybe 2008, nine, I remember reading this stuff and kind of being interested in it. Yeah. But my sense was that it wasn't, it didn't hold up very well. Well, I think a lot of it is these kind of one-off studies which are quite interesting, but that also, basically I think that the tricky, so when I say like this is your brain on God, I'm being very facetious, because I think that obviously experiences of something like God are, first of all, multimodal. So there's a lot going on. There's like a sense of presence. Some people might have a vision. Some people might hear a voice. And so we're trying to really like hone in on a specific contrast that we think would be of interest. So like in all of, in this whole experiment, people are speaking in tongues. And then they describe a moment during the speaking in tongues experience where they basically have the feeling that now the Holy Spirit is present and now their body is being taken over or now there's a voice coming in. And so we're trying to use those specific moments where there's an alteration of agency and compare that to the moments right before or right after. Yeah, I remember they were getting like nuns and Catholic nuns and professional meditators. And when they would reach their peak of their experience they would click. And that's when they would do their scan or at least be aware of in a dynamic scan if that's the point. Yeah. Tanya must know about this. No, yeah, I mean, a lot of it is Andrew Newberg's research in there. Yeah, so we have definitely been inspired by that and kind of checking against that. Does his particular work hold up in any way some of the parts of the brain that he identified? I mean, I don't really think that like has it been replicated. What do you mean by hold up? I remember the right pride or love for some reason. That was like a special orientation. I mean, I just think the important point is that I don't think that the idea that like religious experience or like peak experiences or something are gonna be, first of all, they're just not a monolithic thing, right? So I think we have to be very specific about what phenomenology are we targeting and what is the specific contrast that we're interested in, right? So here we're really interested in this modulation of agency. And I just think, you know, so I would have to kind of go back over those papers to see if there's a specific phenomenology that they relate to those brain activations or deactivations, you know? But I don't think the idea that there's some kind of like general signature. Number one in particular was a mystical feeling of union with the divine. So that is, it's not agent, it's not present. Yeah, so that's very different. It's different, yeah. And those might coincide in some cases or kind of be comorbid to some extent, but yeah, I just, but even that idea like mystical union is a very complicated phenomenological category. Like people might use those words in very different ways. You know, that's an issue that comes up a lot in the psychedelic literature where they're talking about ego dissolution. And there's kind of a growing critique of that concept too that, you know, what is the ego? What does it mean to dissolve? It can be positively valenced, negatively valenced. Do you become unified with things outside of you? Is it more of like a dissociative unification experience? And so there's like, I just think it's really important to be quite precise about the phenomenology if we want to make any, yeah. So I just want to, so basically like, I just want to say about, I think, yeah. So I just want to basically say that the Tulpa Mansers are interesting. So Tanya already kind of spoke about these people, but it's interesting, first of all, because they're not in a religious context. So Tulpa Mansers are basically people who create imaginary or, you know, they use their imagination to create a sentient companion that occupies the space of their mind with them and that they kind of share their body and their mind with this other being who they've created. And I mean, we could talk about Tulpa Mansers for a long time, it's kind of a fascinating thing, but the one thing that I want to point out in this context, and then Samuel will have his own take on it too, is that Tulpa Mansers, I think, are a very exciting experimental population for better understanding mechanistically how these modulations of agency happen because they're very, you know, they've trained themselves to have kind of another voice in their mind or another agent in their mind who can actually cooperate in cognitive neuroscience studies. So for instance, I'm just gonna go fast here, but basically, you know, so now we've designed a task inspired by work by Quinton Deely in hypnosis in the using hypnotic suggestion, but here we basically design a task where we can have inner thought experiences like finishing a simple sentence in your mind, but we can either ask the subject to finish the sentence in their mind or we can ask the Tulpa to finish the sentence. So we can actually kind of look very at specific episodes, like specific events with a brain scanner and have this very deliberate modulation of agency where we see in one condition that people are saying, I have full control over this thought and then I have full control over the writing down of the thought or I have no control, it's completely the Tulpa that's thinking the thought or writing down because they can actually take possession of the body and write and do things like that. So this is kind of an exciting experimental opportunity for us to actually try and see because I think it's quite an exciting idea that there are people who have actually trained themselves to deliberately modulate their own sense of agency over their internal thoughts and their motor actions in the world. So, oh yeah. Okay, sure. I guess I'll try to present a brief, entirely deflation is the kind of Tulpa mancy because for me, Tulpa mancy is interesting precisely as you pointed out because it may illuminate some fundamentally normal universal cognitive and social mechanisms through which such things as illusions of agency or the self, et cetera, might emerge. So I started working on, conducted a 10 month cyber ethnography of Tulpa mansors in 2014, 2015 in which I used a few psychological measures like absorption, sociability, social cognition and that sort of thing. And it was at that time that I started collaborating with Lawrence Kermire who became my mentor and Maxwell Ramstead and most of the ideas that I had that became my contribution to the cultural affordances model came from Tulpa mancy. So one of the first insights that I had is that, isn't it interesting that the experience of voluntarily conjuring an imaginary friend, an imaginary companion, that eventually becomes experienced as automatic as basically a semi-permanent auditory hallucination but it's not accompanied by any kind of distress. Isn't it amazing that this kind of experience is possible? So this is when I started thinking about the notion of regimes of attention. So briefly put, these experiences are possible when a group of people more or less organically create a set of goals, some social norms together to the extent that these experiences are desirable and sort of rewired it, okay. But then I was also very interested in the kind of basic human cognitive machinery that makes these experiences possible. The experience again of having a being that lives inside your head or of having a hearing voices, for example, in a non-pathological sort of manner. So you may recall from a few days ago the model of thinking through other minds that I presented where the basic idea is that our mental experience is always saturated with crypto-Tulpa or proto-Tulpa or Tulpa-like experiences because we're always sort of invariably thinking not just about, but through other minds. So if you find yourself walking down the street and then all of a sudden you see something interesting, you take a picture and you send that picture to your friend because you know your friend would have found that interesting. So what happened prior to that is you had a sort of a proto-Tulpa moment where you were seeing the world through your friends, through the perspective of your friend's desire, for example, you were basically thinking through the mind of another person. So the basic idea, the very long story short, is that because cognition is already social, because we already have many, many mental models of other people in our minds that guide our everyday action and perception, then once you have a cultural context that basically trains, that rewards these kinds of experiences, then you can have something like Tulpa-mency or indeed you can have something like an organized religion where people eventually communicate with deities. So that's the, oh, pardon? Yeah, so that's about all I have to say in terms of why there's nothing that extraordinary about Tulpa-mency is just an emerging interesting cultural context that happens to tap into or to harness those fundamentally normal kinds of experiences. So Mikey, do you want to? You can probably, I mean, basically here now it's kind of leading up to your tyranny. Well, is this not that? No, please, tell us a bit about what you're thinking though, because you are the real and serious neuroscientist scholar of meditation. I mean, so it kind of backed thinking again about context in the study of meditation. So it's actually, this is an example, this is a meditation studio in Manhattan where you can pay some amount of money to book a little room for yourself to take some time out of your busy day and meditate or take a meditation class. And it's just kind of, you know, there's something interesting about this imagery of being in this concrete square with this wall of plants, but, you know, so basically meditation has become, definitely taken out of the context in which it used to be, you know, like out of Buddhist context in Asia and different contexts around the world and it's been kind of extracted in a particular way and now offered to, you know, executives and also patients in hospitals and so on, but there's this kind of question about what happens when you extract practices in that way. And we think that we have like the key active ingredient of meditation is this kind of mental training, but is there something about actually the worldview or the kind of value system or the social structures that these practices were embedded in that might actually be important in shaping what we get out of them or how they, you know, maybe some beneficial effects that they might have for us socially. So this is actually just an article that came out like three days ago while I was at this meditation research conference, which was kind of interesting. And basically it came out in The Guardian. I mean, it's kind of a controversial idea, but the idea here is that basically mindfulness is also a very convenient thing for a kind of late capitalist neoliberal agenda where the idea would be that, you know, when living in precarious social conditions, we can turn inward and kind of find our own inner resources. We don't have to rely on other people. We don't have to change social structures because we have all the resources we need inside and that this is actually kind of a quite a problematic way that mindfulness could be used to kind of justify social injustices or different kinds of structural problems that we should actually be dealing with more head on. I mean, this is complicated too because there's obviously an engaged mindfulness movement and there's a lot of people who think that, you know, kind of understanding our own internal experience can help us be more effective agents of change in the world, but it's an interesting thing to consider the ways in which the mechanistic science of meditation, so like explaining that meditation is this kind of internal, you know, almost like solid, well not solipsistic, but like very individually oriented mental training exercise can actually change, like it can shape the way that public discourse around meditation emerges, right? So if we think that meditation is about being engaged in the community and having certain kinds of social relations, then that might help this kind of trend of meditation actually be more directly engaged in thinking about how we might wanna shape our social institutions in a way that will make us happier or, you know, whatever our values might be. You know, there's also this kind of idea that when we take these practices out of their social embedding, we might actually run into lots of problems like where some people might meditate a lot and then it can actually lead to like certain psychotic experiences or different kinds of adverse effects when there's not a proper context or a kind of proper social support system. So Willoughby Britton is someone who has been doing a lot of work kind of revealing some of the adverse effects of meditation practices that are normally not discussed and one of the projects that we have that Lawrence has been involved in is trying to think about how the narrative framing of these practices can actually, you know, be very crucial in terms of protecting people from these kinds of adverse events or, and also just shaping the outcomes in a positive way. Another thing, Evan Thompson, who's like a very important philosopher and theorist in this whole conversation around meditation and the science of meditation, just finished a book called Why I'm Not a Buddhist, which is just kind of an interesting thing to have on one's radar. I don't really know what his argument is but presumably, I guess the main point here is to say that there's something, even within the domain of the field of meditation science, there's this kind of growing recognition that we need to be more aware of the way that these practices are contextualized in terms of understanding how they work and also thinking about how we want them to work in our culture. So, I mean, so one kind of interesting thing is that there's this idea that like mindfulness is all about being in the present moment, right? So here's like a quote from Eckhart Tolle, who's a kind of important, I mean, he's not really in the mindfulness, you know, movement per se, but he's in this kind of like coming back to the spirituality, spiritual but not religious in a Western context. And there's this kind of idea that the past has no power over the present moment, the future is an illusion, the past is just kind of a reconstruction. The only thing that's really real is now. And obviously there's some kind of truth to this, but there's also something a bit, you know, problematic or potentially dangerous in the idea that where we come from doesn't matter, where we're going doesn't matter, all that matters is paying attention to now. You know, clearly like if we're ruminating in some kind of depressive way, or if we're like overly obsessed with how things might end up, then that can also be somehow out of balance or not a helpful approach to things, but there's also potentially some kind of over valorizing of the present moment, which is part of I think what's happened in this extracting of mindfulness from the original context, where actually if you look at like Buddhist practices, a lot of Buddhist traditions really emphasize the importance of holding the proper view and understanding of what these practices are gonna do for you and what they're gonna do for your community and how the practices are always communal from the get-go. And so there's really not, I mean, clearly the present moment is important, but there's also this whole narrative and kind of like individual narrative, also social narrative and historical narrative that is always in play in mindfulness and in meditative practice. So with that, I will leave you to hear. Where's my other slide? Oh, yeah. I'm not quite sure how to go about this. I just wanna end by sharing a few thoughts and questions and hopefully a conversation. The question that interests me here is the place of the mindfulness craze in a really interesting historical moment, presently historical moment where using the predictive processing metaphor, we may agree that there's a really, people have a really interesting and strange relationship with temporality and with the self and others in ways that may be quite historically novel. And I wanna just interrogate the place of mindfulness culture and the craze for mindfulness in this present context. So a brief analogy first, some of you may have read a wonderful little book by the journalist Michael Pollan long before he got interested in psychedelics, a book that he terms in defense of food. So he makes a very simple argument.  Just eat things, you know, where you can recognize the ingredients or, that's interesting but not very relevant to our argument. But in that book, Michael Pollan presents the outline of a very interesting idea which is a question that he poses about dieting culture. So he says, it seems you could note empirically that whenever a culture is obsessed with dieting and you see lots of like dieting fads and trends, you know that there's a really problematic relationship with food and probably even with the body. There's something weird going on. And he says, at face value, you could understand, say, the slow food movement or different kinds of diets and diet fads as probably good adaptive remedial strategies to deal with, for example, the problem of growing rates of obesity. But not so, says Michael Pollan. Michael Pollan says, no, no, no. He says, diet culture and obsession with different diet fads are part of a very perverse feedback loop that perpetuate a rather toxic relationship with food. So the question I wanna ask today is, could it be that, and I'm gonna talk a little bit about the kinds of social pathologies and individual pathologies that are on the rise and to attain the hypothesis that mindfulness is not simply not just or perhaps not at all a way to remediate or to deal with a set of growing social anxiety, but how mindfulness culture in those practices may be part of a very perverse feedback loop that perpetuates sort of a problematic relationship with the self and others and also with temporality. So another brief analogy to try to historicize the mindfulness craze in what's going on right now again. Alexi de Tocqueville, some of you may know, very famous 19th century social scientist who's known for his works on democracy in America, but less well known but really wonderful book of his is on the old regime and the French Revolution where he examines the historical conditions that lead to the French Revolution and then he sort of ways, he evaluates the pros and cons of really rapid social change. But Alexi de Tocqueville is also sort of an early diagnostician of some predictable problems that arise in cultures that become quite individualistic. So without doing justice to de Tocqueville, he says in most traditional pre-modern societies, people integrate predictable social structures.  So in traditional societies, people typically, for meaning they typically look towards the past, towards the history of their people and the past is predictable. There are stories like say, for example, like in a Passover ritual, the story of the flight from Egypt is retold, solidarity and so forth. And then there's a predictable path towards the future as well. Now in modern societies where all predictable social structures have vanished, it befalls on the individual to reinvent herself, everything from her personality, her talents, her life partners, her jobs and so on and so forth. And with this opening field of possibilities, so too opens the field of anxiety. So anxiety may be an important part of the human condition but it certainly is an intrinsic part of the modern, the post-modern human condition. So of course we could understand again mindfulness as something, an attempt, a sort of relatively organic social attempt to reintroduce some predictability, to reintroduce some structure, to reintroduce meaning and to reintroduce some probably good self-regulation strategies to deal with the fact that in the present moment the future is extraordinarily entropic and so is the past. So for young people, and I say this with compassion, not without irony, there's a lot of anxiety about how the past was really oppressive, there's victims, there's perpetrators. So the past has become less predictable as well. So I won't have time to go into the full argument here but I would like to propose that some of, even without worrying too much about the cultural intent and the cultural appropriation about how some of the practices of ruminating are staying in perhaps the wrong kind of present and by blocking off the future and the past through mindfulness may not work very well. So a few arguments that have been made against the tyranny of the present moment, a rather controversial book by Amy Chu and Jeb Rubenfeld, both professors at Yale University, The Triple Package, where they claim to identify some traits that some cultural groups that were people on average do quite well have and they say, so one of them is cultural pride, having pride in your group, pride in the past, some kind of again predictable social structures. One of them is actually anxiety about the future. One of them is really high aspirations, social norms that invite not so much living in the present but looking towards higher aspirations in the future. And the third one is something like endurance in the face of adversity. So they say America's obsession with the present moment is absolutely catastrophical, it's disastrous. They say America is the greatest record of impulse control. They said rather, we should also be cultivating self regulation by looking towards the future and of course by doing this collectively, by having access to a group, to a culture, to common narratives. So again, not much time to get into this. Victor Franco, the Viennese psychiatrist who survived several concentration camp and wrote a book called Man's Search for Meaning which is an externally hopeful book. It's really, if you haven't read that book and if you read it, you'll probably cry a few times but more from joy and hope at seeing just how well humans can thrive and adapt and survive. Now Victor Franco is interesting because like, you know like Wittgenstein or others, or De Tocqueville, he's invoked by people with different political agendas. Some people of course find his stoic message a little too individualistic because he says, for example, you know, the one thing that can never ever be taken away from you is how you choose to react to events. So your dignity, for example, can never be taken away from you. But another really important sub-theme in Victor Franco's book is the importance of purpose, of meaning, of narrative, of having something to live for, of having something to look forward to. So for many people, he points out that's relationships. People made it through the camps because they knew they had maybe a son, maybe an aunt, maybe someone waiting for them and that was enough or for another one it was a scientist like his work. Like there were so many questions, so many questions left to answer. So mindfulness, there's something odd. Again, without worrying about immeasurable things like cultural appropriation, isn't something odd about this obsession with practicing compassion but doing this alone, just having this ritual of, you know, so many times a day you have to sit alone and think about how compassionate you are without, for example, just simply spending time with others or again, not just caring for others but as Otto Kernberg, the psychoanalyst, would say daring to depend on others. So again, could it be that there's something accidentally toxic and fragilizing about the culture of self-care where we're always sort of rehearsing some unexplained anxieties in the present without really crafting some narratives together, something to look forward to together. So I could go on and on, but this is just a gist of the critical argument that I wanted to present and I would like to open the floor for discussion now. I think we've spoken for a very long time. It's also five. Oh, it's also five. So let's take five or 10 minutes, five minutes, for any of you who just wrote some precious comments to have a little closure and then people can go off and meditate on you. I would just say that I think an important counterpoint to Victor Franco was Cremolini, the grounds of the say. Sure. Because there is always a risk when you talk about people who survive, they have a good attitude that can create a misleading, in a sense, heroic narrative. And yes, it's probably on balance better to have, you know, as one's own being, making capacity to find me, but that's not always under people's control. And so just along with your critique of the sort of the neoliberal thing that's going on with all these practices, I would say there's also a risk that trying to unmask the poor me or the wounded bird kind of scenario, you play into accounts that don't want to acknowledge just how powerless and just how crushed that many people are in their lives. So both things are going on. We're trying to expose them to a step forward. I said, look, child abuse is more prevalent than you realize, but it becomes a problem. People say, well, this explains everything now and I have no agency and no possibility of life. And every small version of this is that is the worst. Those are all the excesses. So somehow have to recognize both extremities and co-optations for a more wise little role with these people. For sure, for sure. And as I'm sure you'll recall, Victor Franco was, he wanted to publish his book anonymously. He was reluctant to be celebrated as a survivor. He said, in fact, for sure, the best one of us did not return because the things that people have to do to survive sometimes, they really have to forego their basic solidarity and humanity and absolutely. But I'm trying to make- Now that they're torn down to sort of early functioning public states, it's only a caution that- Of course, of course. ...the process of pointing to what I agree with totally in terms of commercialization and the narrow view and the co-optation of all these things. We're sort of the same thing. It's interesting and worrying to see that the more we're obsessed with mindfulness, the more as a society we appear to sort of be unwell. So there's a perverse feedback loop somewhere and we're trying to make sense of it. And the point about narratives, again, even if people pick a story to live by, even if they pick a philosophical story like Stoicism, the point that never gets mentioned is that no one can invent Stoicism on their own. There's a long cumulative history of traditions being kept alive, being taught, being relearned, and that's- There's something fundamentally collective about that. And without those narratives that help frame our relationship with the future and indeed with the past and the present, then we can't thrive, we can't live well, and we can never do that alone. You know, as you're talking about, what's thinking of Julia Cassidy's recent work on mindfulness culture? Michael, you must know, you must be aware of some of that. Yeah. But, you know, she's doing work, her work is in Thailand, but then also she had a comparative study in Sri Lanka and Myanmar as well. And she was struck by how a lot of hospital settings, Buddhist, you know, meditative, relearning mindfulness from often being like Western expert, really. Yeah, so it was being re-exported to these, you know, Eastern context. And they were trying to learn it the right way, you know, from these kind of Western, kind of medical interventions. And when she would try to talk to localists, you know, Julia's like, well, you all know this is your tradition. And they actually often had a lot of knowledge and they had their own practices. But it was often, you know, it was often that it was kind of unconscious and very socially embedded, not codified in the same way, so not as exportable and all that. So a lot of the stuff that you're talking about with like the kind of social disembedding of it, there are other possibilities out there as you well know, it's just they're coming into conflict with this more dominant. Possibilities you mean to be well? Well, there are other mindfulness practices, you know, still among, I mean, you know, Julia's book, Living Buddhism, it shows how these mindfulness, kind of awareness of the fragility of the ego and all these things you're talking about, but in a very different Thai context, they're very helpful to people in all sorts of ways. Yeah, but there are some things like visiting the Sikh, taking care of your nephew, calling your grandmother, just, you know, there are like really simple things that humans appear to have known for a long time that they kind of pushed aside as we're obsessively nurturing this kind of lonely self-care.  That seemed to be very helpful to people. Yeah, yeah, sure. I mean, there's a lot of other pieces to it, but that, it was a kind of a perspective which is tied in part to what you're saying about, you know, we have these future agendas and we have a past, but on some level, it doesn't even matter because we're at the, you know, there are these big forces out there that are driving our lives and our fates and so forth. The present moment is shaped by priors that go way, way, way back phylogenetically even and it's always tending towards the future, right? Even as Alan Young says, memories are about the future for the future. So we might as well find cultural practices that cultivate this relationship with temporality well as opposed to attempting to block it off. I mean, for me, an important lesson to take from your critique and your sketching this case study is to think of all these practices not in isolation, but as part of a form of life and then to have a moral, aesthetic, political, whatever critique of that form of life because that's what's really coming along with it. And even when people, the irony is when even people present the technique as disembed, in fact is carrying with it a form of life. So if it's, this is MBSR and it's a purely scientific technique and you can just use it and apply it to whatever you want, well that is a neoliberal notion that you don't have to consider what your ties are to other people or whatever just maximize your functioning. That leads to a certain kind of community that leads to a certain form of life. So I mean, I think that opens the door to saying there may be many merits to different traditions but we should not just be saying, what does this little thing do or what part of the brain does it light up? But saying, well what does this form of life look like? How do people treat each other than when they follow this kind of path? I mean, for me that would be, and that comes back to the why I'm not a Buddhist thing. I mean, I just read the book on Amazon and it's definitely about this disembedding kind of notion and the idea that by bringing Buddhism at the top of the same, by bringing Buddhism and science together, we'll get everything we need. And he's proposing, and consciously we need to start from Paul to Nezha which would be again to say we have to be alert to this larger world that we're living in and where all these different practices are situated. I recall you had a talk called why I'm not a Buddhist years ago, in 2015 or so. You said those words, I wanted to write a paper along those lines and now there's no point in it. I mean, it's okay. He beat you to it. I'm sure he did. He beat better than me. And it could become a meme where everyone- Well, I think I'm gonna write an essay. I'm just to tolerate this. This would be why I, too. Yeah. But I'm still thinking of the actual Buddhist or why you're not the same way we got ironically here. Yeah. Well, and the point you made is very well taken. At the Mindfulness Conference, the workshop that we had here, Lauren Lief presented work from Nepal, showing that people in Nepal, Newar, and Buddhist are the MBSR. And they don't know much about it and they're not practicing their own tradition. But their own tradition was not. The other point isn't most Buddhists are patient, it's not a particularly important part of their practice. The most Buddhists were doing great action. They were learning teaching stories and whatever part of the community. For people outside monastery, that's the biggest part of it. I think it's also interesting, because we began to have a world over living and now what's a response to what I'm thinking that Buddhism arose in the context of a pretty rigid society with caste and lots of challenges that people were facing. And the idea that somehow this was a way of getting beyond the inevitable suffering. I could say we're letting them. That's right now also. So maybe in some respects the moral philosophy is fit for purpose in the current context. Recharge, we'll come back. Well thank you everyone. Thank you.