Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence
Evidence that mindfulness works for treatment-resistant PTSD and other forms of trauma, but mechanism of action remains unknown. I propose that this is due to modulation of dopaminergic tone which makes one more susceptible to reprogramming, and that this tone can be manipulated by pharmacology, electricity or the combined behavioral approach in the Nibbana-protocol.
Zone 2 training and tonic dopamine
Sustained, moderate-intensity aerobic exercise (“Zone 2”) has been shown to increase tonic dopamine tone. PET studies in humans and treadmill studies in animals consistently demonstrate that regular endurance exercise upregulates D2/D3 receptor availability and enhances baseline dopamine signalling capacity. This represents a long-term shift in the dopaminergic system — a higher, steadier “set point” of tone.
(Heijnen et al, 2016, Gorrell et al, 2023)
HIIT and phasic dopamine
In contrast, high-intensity interval training (HIIT) provokes acute phasic dopamine release: sharp bursts that are rewarding but short-lived. Phasic spikes do not produce the same receptor-level adaptations seen with Zone 2 training.
Implication for practice
If the goal is to cultivate stable baseline dopamine tone — resilience, sustained motivation, and reduced craving — Zone 2 aerobic training is the more reliable foundation. HIIT would encode the opposite behaviour. We are using exercise as a form of meditation and a way to train ourselves away from reliance on phasic spikes for reward.
Meditation and tonic dopamine
Neuroimaging and pharmacological studies show that meditation increases baseline dopamine tone. PET studies of mindfulness and concentrative practices reveal reduced [^11C]raclopride binding, consistent with elevated endogenous dopamine release in the striatum. This suggests that meditation stabilizes tonic dopaminergic activity, supporting calm focus and equanimity.
Meditation and phasic dopamine regulation
Meditation also alters the brain’s sensitivity to phasic dopamine bursts. EEG and fMRI studies indicate reduced reward-prediction error signaling and dampened reactivity to external stimuli, consistent with a recalibration of the phasic system. Over time, this blunts compulsive reward-seeking and supports voluntary attention.
(Kirk & Montague 2015; Tang et al. 2015)
Implication for practice
Through repeated training, meditation shifts the balance toward higher tonic baseline dopamine and lower phasic volatility. This may underlie the subjective reports of sustained clarity, reduced craving, and greater stability of mood associated with long-term practice.
Seasonal dopamine rhythms
Dopamine levels in the brain show seasonal variation. PET imaging demonstrates higher striatal dopamine receptor availability in winter compared to summer, likely reflecting seasonal light exposure and melatonin–dopamine interactions. This shift affects mood, motivation, and reward sensitivity across the year.
Circadian regulation
Dopamine also follows a daily circadian rhythm, peaking during the active phase of the day. Animal studies show rhythmic expression of dopamine receptors and transporters, driven by clock genes. Disruption of circadian rhythms (e.g., by irregular sleep or artificial light) destabilizes both tonic and phasic dopamine signaling.
Implication for practice
Exposure to natural light, regular sleep, and seasonal awareness all help maintain dopamine balance. Aligning practice and exercise with circadian and seasonal rhythms may support steadier tonic tone and reduce vulnerability to phasic dysregulation, especially in darker months.
Additional References
Tonic dopamine and biases in value learning linked through a biologically inspired reinforcement learning model.
Provides a computational and empirical model linking tonic dopamine to biases in value-based learning, supporting the conceptual distinction between tonic baseline tone and phasic reward signals.
(Romero Pinto, S., & Uchida, N. (2025).
The dopamine hypothesis of bipolar affective disorder. Bipolar Disorders, 21(6), 571–583.
Review linking elevated striatal D2/3 receptor availability to mania and dopamine transporter dysregulation to bipolar depression, emphasizing the clinical relevance of tonic and phasic dopamine balance.
Human REM sleep recalibrates neural activity in support of memory formation
Human REM sleep helps regulate (i.e. “recalibrate”) neural activity, supporting memory re-encoding and integration. It looks at how REM plays a role in reorganizing neural representations after learning.