Cathy Kerr

Embodied Cognition and Health with Cathy Kerr (LBP 056)

catherine-kerr
catherine-kerr

Cathy Kerr is the director of the Mind-In-Body Lab at Brown University. Her research focuses on whether brain rhythms underlying body awareness and movement are actively modulated by mindfulness and movement practices such as Tai Chi and Qigong. Her hope is that understanding how these therapies work will have a positive impact on conditions like aging and chronic pain or functional disorders where these approaches have shown the clearest therapeutic benefit.

She joined me today to talk about the focus of her research broadly, but also to discuss a specific research study that is in progress which is looking at the effects of Qigong on distressed female cancer survivors.

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Conversation highlights

  • What does her research focus on? The status of body awareness as a therapeutic mechanism and looking specifically at mechanisms related to body awareness in the brain; How neurons process and relate to body focused attention, primarily in the somatosensory cortex.
  • Became interested in body awareness originally a Qigong practitioner because of having a difficult chronic illness for 20 years. Cathy noticed that with her practice the sense of touch in her hands would change.
  • Started to wonder if body experience could be part of a therapeutic mechanism. Was it a way of signaling healing? Or a very active way of creating the placebo effect?
  • Initially began researching the placebo effect with Ted Kaptchuk at Harvard
  • In 2005 departure from work on placebo and learned the neuroscience of body awareness.
  • First project to look at the effects of body awareness within a healing technique- for that technique they ended up choosing MBSR (mindfulness based stress reduction).
  • It was paradoxical because they were not a part of the mindfulness research community, and mindfulness as a body based healing technique not the majority view.
  • The study showed that after 8 weeks of MBSR training people were better at exerting pinpoint control over neurons in their somatosensory map.
  • Cathy's TED talk mindfulness begins in the body.
  • There is an interesting suta by the Buddha- the 4 foundations of mindfulness, and mindfulness of the body is the first foundation. Cathy wrote a review paper on this in 2013.
  • Cathy's teaching with medical students at Brown how to have immediate access to body sensations as an anchor for mindfulness.
  • This is an immediate way of stabilizing the mind. For many Western people their mind can be floating free and ungrounded and anchoring your mind in the body is very powerful.
  • Some people don’t even know that they can voluntarily shift their attention to their body. (story of a man who jumped away from his own hand because he was so startled when he shifted his attention to it).
  • Many people with chronic pain, and IBS don’t have that ability to bring the mind to the body. The reason is that they are already always preoccupied with these negative body experiences.
  • What’s really exciting right now is that The Davidson Lab has begun to look at the effects of mindfulness and exercise. They are bringing mindfulness off the cushion. It really helps people to understand a broader range of embodied approaches like Tai Chi, or yoga.
  • At the University of Washington Dr. Cynthia Price is working with assisted mindfulness in people with trauma. In  assisted mindfulness a bodyworker helps them to be and stay present while they work with mindful attention to body sensation.
  • Cathy's current study on the effects of Qigong on distressed female cancer survivors.
  • She chose Qigong because she wanted to see what would happen if researchers expanded the number of modalities they looked at in addition to just mindfulness.
  • There is a novel undertanding of how the mind and body relate in Qigong. The hope was that they could capture these ideas and understand them in scientific terms
  • Cancer survivors are really underserved and have a lot of psychosocial needs. About 30 to 50 % of them are actively fatigued and distressed for years following cancer remission. Is this chemo? Existential effects? They don't know but the main thing is people are not able to return to their full lives. The whole pink ribbon campaign doesn’t really capture this reality.
  • Gentle physical movement in a group can really transform people’s experiences. The question is why, and how does it work
  • Inflammatory cytokines show an up-regulated process of inflammation going on in the body. Especially in people who are highly fatigued. This process of inflammation is really important for many diseases.
  • There are now some markers in blood that we can measure- giving insight into this process of daily inflammation. They are associated with feeling sick and tired daily. If you are bathed in inflammation for years it can bode poorly for susceptibility for many issues like heart disease, vascular disease, it is associated with dementia... Getting a better understanding of inflammation is one of the main scientific tasks right now.
  • We know that if you are injected with one of these inflammatory cytokines you will get "sickness behaviors" like not wanting to get out of bed and feeling generally unwell... but we don’t know how to clear these inflammatory cytokines out.
  • There is an old Chinese folk saying- the mind (yi) leads the qi, the qi leads the blood.
  • This seems to suggest a solution to the puzzle of qi. So if you behave as a scientist you can measure the mind and its ability to focus on the body. You can measure the yi and the blood... So maybe that is a pathway of how mind intent or somatic awareness might have an effect on parameters in the blood like inflammation or the ability of the blood to flow through the body.
  • Embodied cognition: many philosophers have gone on this mind trip and have posited these ideas of brains in jars and brains in vats- that we can only look at brains. They are saying no there is a relationship between brian and body and body and world and if you miss that you miss everything.
  • Interoception research has been a very brain centered endeavor to the point where all the relevant processing is considered to takes place in areas in the brain. But in fact there is a lot of bodily signaling from the heart and other centers.
  • Neurons in the body have their own way of processing experience and an ability to send independent sources of information that are not simply sensory through-puts but are actual information processing. There are independent sources of information and embodied cognitive processing to help the body in the brain.
  • We want to measure different forms of connection between the hand and the brain. Want to see if that changes during the course of practice.
  • We hear a lot about consciousness. One of the main factors is something called a brain rhythm. The gama rhythm is of consciousness. There was a study in 2004 of Tibetan monks doing compassion practice gama rhythms go off the charts. It turns out these rhythms also extend into the muscles, and these rhythms of consciousness that extend into the muscles also relate back to the brain.
  • The beta rhythm is a stopping rhythm. It’s very operative in thinking and in moving. If you need to hold something in memory beta says no more info for a bit please. Beta becomes disregulated in parkinson’s disease. Measuring beta in Qigong. Looking at quality of information that the muscle spindle neurons send back to the cortex.
  • Curious about if that somatic awareness has effects on the ways that the muscles process information. Do some of those effects tell us anything about changes in blood flow or in inflammation?
  • The rubber hand illusion tells us that there is this very interesting multi-sensory body sensing capacity.
  • It tells us that our sense of the body is being knit together by these different streams all the time.
  • Their biggest hope with this study is that they will learn something new about how some of these body awareness practices like Tai Chi and yoga might have an impact on inflammation. It could be a novel mechanism for understanding inflammation. That’s the big home run hope.
  • Being able to have an impact on the distress of this population would be wonderful.
  • Cathy asks me is there a discussion about the intelligence of the body? How do I as a practitioner use that? \
  • I talk about the Liberated Body tribe- most of us are in a variety of manual and movement therapies. The thing that makes us all stand out is that we have a reverence for the body - we believe in its importance to life.
  • My life changes the more engaged I am with my body.
  • As a larger group the thing that makes us different in terms of the broader culture is that we talk about the body as something critical to a rich thriving life.
  • Cathy: there is so much wisdom in people who are carrying that out in a daily practice. There are so many of these practices across all cultures. There must be something universal about this, it's not just something people are making up. I’m excited about people engaging with the science.
  • Fascia research: We are all learning how the nervous system and the connective tissue scaffolding are so intertwined.
  • There is a lot of exciting sense of possibility. It’s like we discovered we have the amazon right here in the body.

Resources

Dr. Cathy Kerr's Mind-In-Body Lab at Brown University

Cathy's TED talk: Mindfulness Starts in the Body

Cathy's paper in Frontiers in Human Neuroscience Mindfulness Starts with the Body

Mindfulness Based Stress Reduction (MBSR)

Ted Kaptchuk and placebo research 

The Davidson Lab

University of Washington Dr. Cynthia Price

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Interoception in Practice with Bo Forbes (LBP 053)

Bo Forbes is a clinical psychologist, yoga teacher, and Integrative Yoga Therapist. She and I had a chance to talk way back in season one, and today I'm delighted that she joins the show again. A central guiding theme of Bo’s work is with interoception, and she has put together the Interoception Tribal Council which is bringing together researchers, primarily neuroscientists, who are looking at interoception and its effect on the whole person’s health both physically and mentally. In this conversation we talk about some of the amazing research that is coming out these days, but we also talk about her own experience putting her interoceptive abilities to the test when she underwent hip surgery this year- which was her 4th hip surgery in 8 years. It’s a really beautiful story of living one’s practice. I hope you enjoy it as much as I did.

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Conversation highlights

  • The creation of the Interoception Tribal Council- who is participating and what are they working on together?
  • How has interoception become a central part of Bo's work?
  • Bo talks about the study by David Creswell which demonstrates that mindfulness leads to reduced inflammation markers in the body.
  • Remarkably, these changes were absent in people who practiced relaxation without mindfulness.
  • The Default Mode Network of the brain- thinking about the past, wishing things were different, imagining what things will be- the tendency it creates towards a negative self-referential way of being in the world. "I am not worthy" or, "I will never get what I need" messages.
  • This DMN (Default Mode Network) plays a huge role in depression. Mindfulness separates this mode from direct experience. This creates changes in the brain related to depression.
  • The Creswell study encourages specifically people to pay close attention to their bodies- even to notice the negative feelings in their bodies- so he was leading them in increasing interoceptive awareness.
  • Bo's hip surgeries- two doctor errors and one hospital error led to 4 surgeries in 8 years. There was a strong PTSD issue with this, and a compelling narrative that made her look closely at chronic pain, the DMN, and interoception.
  • The idea that someone had damaged her body and ruined it forever was pervasive in her life. The tendency to look for and predict the same pain she had felt the day before. It made her very stuck.
  • Bo's choice to not be put under general anesthesia during the surgery- how that changed her interaction with the doctors and nurses.
  • How Bo used her interoceptive practice to manage the experience of being awake through the surgery. Her intimate relationship with her breath and heart rate in order to maintain staying awake for the surgery.
  • The direct impact the lack of general anesthesia had on her rate of recovery. For whose benefit are patients put under? Is it perhaps a protocol that has become so automatic that it never gets questioned? What happens when we question its necessity?
  • Based on the Creswell study, cultivating this interoceptive ability also likely has a remarkable effect on immunity and the experience of pain. It was amazing how many times in the hospital they wanted her to take something but she didn't need it because she only had some soreness.
  • It's also clear from this experience why we don't want to be in our bodies. Our bodies can be like a vacation home that you haven't gone back to in years and it's gone into disrepair- as you approach that home that hasn't been inhabited in a long time its intimidating.
  • We get deliberate training to be out of body and to focus mostly on what is coming in through the visual cortex. Trauma also makes us not want to be in our body. It doesn't feel like a safe space to be in the body.
  • Nervous system hyper-arousal is a form of collective trauma that we all go through in our culture.
  • Being disembodied is also a form of trauma.
  • Connective tissue has this amazing linkage with interoceptive awareness. Using self-care methods like Yoga Tune Up or MELT- these are objects without emotional load that can help us to check in with our bodies.
  • Just putting our hands on our bodies and bringing attention to our bodies and where our hands meet our bodies can be so helpful.
  • In modern yoga in our culture we have a focus on proprioceptive movement. We start with action, "do this". Then if there's time we will add in an instruction to breath. Then if we really have time there might be an awareness based cue. In [Bo's tradition] they reverse that. Starting with an awareness based instruction, from that place of awareness they can breath or move where awareness is growing.

Resources

Bo's beautiful post on her surgery experience The Beauty of Broken

Bo's article on the Creswell study in Yoga Journal

The New York Times on the Creswell study

The Creswell study in Biological Psychiatry 

Farb and Segal research on the Default Mode Network and depression

Dave Vago

Catherine Kerr

Mind and Life Institute Fellow Program

Mindfulness Based Stress Reduction

If you’re inspired to support the show, you can do that here. You can also leave a review on iTunes or Stitcher  , or simply tell your favorite body nerds about the show. It keeps the show rolling and connects us more as a community. Body nerds unite!