Mindfulness, cognition, and long-term meditators: Toward a science of advanced meditation.

Mindfulness meditation is a systematic training in equanimity, sensory clarity, and concentration rooted in ancient contemplative traditions. Here, we synthesized cognitive-behavioral outcomes in long-term meditators (LTMs) resulting from diverse, prolonged meditation practices. Preliminary evidence suggests that LTMs exhibit increased cognitive-sensory integration and decoupling of affective processes, demonstrated by enhanced interoceptive awareness, reduced negative affective pain perception, and more rational decision making. Additionally, LTMs may experience more emotional neutrality, malleable self-boundaries, and altered self-awareness. Neuroimaging findings included increased bottom-up activation, particularly within the salience network (interoception, pain, affect), and reduced connectivity between the executive (dorsolateral prefrontal cortex) and salience (dorsal anterior cingulate cortex) networks (reduced pain). The literature also suggests reduced fear and amygdala activation (mitigated negative affect), increased temporoparietal junction activation (pre-reflective experiential processes, empathy), and altered midline default-mode network activation, which was associated with emotional neutrality and non-ordinary states of consciousness. Methodological limitations restricted the interpretation of trait effects, emphasizing the need for a unified framework to systematically investigate advanced meditation's states, stages, and endpoints using neurophenomenology. In summary, LTMs display a distinct neurophenomenological gestalt of mindfulness, wherein meditative expertise is reflected in enhanced cognitive flexibility and integration, self-regulation, and non-dual awareness-signifying a potentially important form of embodied cognition.