There are strong indications that meditation and mindfulness practice may have a positive impact on dementia and cognitive decline.
Authors: Russell-Williams, J., Jaroudi, W., Perich, T., Hoscheidt, S., El Haj, M., & Moustafa, A. A.
Title: Mindfulness and meditation: treating cognitive impairment and reducing stress in dementia
Summary: Mental health concerns linked to an ageing population include, Alzheimer’s disease (AD), dementia, mild cognitive impairment and subjective cognitive decline. We should say at the outset that when people are diagnosed with early-stage dementia, increased stress levels leading to poorer health more generally may follow close behind. This notion was reflected in the aims of this review.
There is evidence that meditation technologies can boost brain function and structure, but there is a lack of research investigating the benefits to populations already suffering from declining cognitive performance. This narrative review examined ten studies that explored the benefits of meditation on dementia-related memory conditions. The study looked across a range of scientific papers to identify trends and patterns. This should not be confused with experimental replication (the repetition of experiments to confirm scientific reliability).
The reviewed studies were seeking to understand if meditation could influence the cognitive performance, quality of life and perceived stress of people already experiencing different degrees of memory-related cognitive decline. The good news is that all of the studies demonstrated significant or ‘moving towards significant’ results. Collectively, these findings indicated that meditation could lead to
a reduction in cognitive decline
an increase in functional connectivity in the brain
a reduction in perceived stress
an increase in quality of life
The bottom line is that meditation appears able to improve brain function in people already suffering cognitive decline. Observed changes are likely to be linked to structural alterations in the brain. These positive developments can, in turn, lead to reduced levels of stress and improved quality of life.
“These preliminary findings offer causes for optimism in the treatment of cognitive decline. However caution must be expressed until results have been reliably replicated.”
The problem in talking about the concept of nonduality is that it is everywhere, all the time, but it is rarely recognised or understood.
Where to begin? Where to begin when there is no beginning? To merely approach the concept of nonduality, several volumes of definitions, meanings and precedents could be used to establish the common ground required for a meaningful introduction. Consider that in traditional training systems an ‘introduction’ to nonduality can comprise a decade or more of study and meditation. Even then an intellectual understanding might not be achieved, and a reliable experiential appreciation is even less likely. But despite the challenges, this is such an important issue that I’m attempting to outline a basic framework illustrating the inseparability of a recognition of nonduality and meditation. Both to write this short essay and also as a foundation for further studies in this area.
From the academic standpoint, there are several ways of approaching nonduality, including the use of art, contemplative science, neuroscience, philosophy, psychology, semiotics and more. However, as this is a discussion of duality and nonduality in contemplative science, I can try a short-cut and align these thoughts to theoretical frameworks from traditional meditation systems. Crucially these established understandings have stable ontologies with reliable supporting and supportive epistemologies. Such theoretical frameworks can be found throughout traditional meditation schools, but are explicitly taught in nondual approaches such as Dzogchen and Mahamudra. This is not to give the first or last word on nondual understanding to a particular tradition, school or sect. The tension between duality and nonduality put simply, is just an elegant way of describing the conscious experience of humans. It is not owned invented or discovered by any one individual or group. Although a sustained investigation by adepts over many centuries means that extensive bodies of knowledge have already been created.
As most forms of meditation shape the cognitive processes underpinning conscious experience, they can be considered as tools able to influence our concepts of duality-nonduality. However a point of clarification is required, everything we think say or do also exerts force upon our ability to recognise the dualism that permeates our lived experience. The difference between meditation and everyday experience is that meditation can be designed to systematically augment our access to nondual awareness (NDA). So when we talk about meditation in a traditional context, nonduality is generally (intrinsically and extrinsically) part of the process and method being used. It is also important to stress that meditation is a very broad church, some forms may not articulate any position in relation to dualistic concepts. The motivation of practitioners is also a key factor in this discussion, people may meditate for many years without ever encountering the path to NDA. Conversely, several people have reported ‘accidental’ insight into NDA without the use of any of the methods known to mediate conscious experience. Further, traditional texts from established meditation schools set out the foundational processes of NDA, which can be seen to be congruent with the scientific understandings of deliberate cognitive transformation.
Contemplative science (the scientific study of meditation and mindfulness built up over the last half-century), is yet to get to grips with understanding the precise nature of the dual-nondual relationship. One of the limitations in the scientific study of traditional forms of meditation is the very existence of dual and nondual consciousness. The assumptions of positivism are that both the scientist and the science are objective, an assertion that has been demonstrated to be dualistic and sometimes unreliable. Therefore, despite its fundamental relationship to meditation, NDA challenges the ontologies of several of the leading approaches within psychology, including contemplative science.
So how to explain dualism to a person committed to a dualistic view of the world? For this, we can return to the preliminary discourses of how does the mind watch itself? The classic cognitive response to this question is that the executive function (EF) holds this task (of self-monitoring). But in reality, we know at the level of psychology and personal experience, the EF is both participant and observer of the drama of our lives. This simply means that most humans flit between the dual and nondual states without necessarily being aware or having any choice in the matter. From a contemplative science point of view, this takes us back to the drawing board, because it is clear we often see the world in both dual and nondual frames according to a range of causes and conditions. NDA isn’t an abandonment of nonduality, it’s just the experience-based understanding of its role as part of our conscious engagement with the world.
Preliminary work by scientists like Josipovic and scholars such as Dunne has started to indicate that nondual meditation methods may have a qualitatively different nature when compared to other practices. But a key point to make is that NDA is not restricted to nondual practices, it is relevant to all forms of meditation (to a greater or lesser extent). However, I have yet to see evidence that the timeless negotiation between dual and nondual consciousness (that characterises most forms of meditation), has been observed scientifically, let alone understood. This shouldn’t be seen as a criticism of contemplative science or cognitive psychology. The full potential offered to humanity by nondual forms of meditation is dependent on grasping the nature of highly elusive mental states, considered to be the ‘result’ of meditation practices.
The good news for both meditation scientists and secular practitioners is that a meaningful understanding of experience-based NDA is not essential for the research and practice of meditation methods. The preliminary limitations in the scientific study of meditation and mindfulness are not due just to a failure to understand NDA, some important progress has been made. But for a fuller appreciation of the potential of meditation, explicit and implicit nondual mental processes will have to be first observed and then understood.
For a basic introduction to non-duality download the NDA podcast here.
Growing challenges to the science of mindfulness is forcing a rethink in how we measure and understand the benefits of meditation.
Authors: Grossenbacher, P. G., & Quaglia, J. T
Title: Contemplative cognition: A more integrative framework for advancing mindfulness and meditation research
Summary: The growing tide of criticism directed against the science of mindfulness, from within the scientific community, is driving a sense that something has to change. Just what that something is, remains unclear. In this paper from 2017, Grossenbacher and Quaglia proposed a new approach for understanding mindfulness and meditation as a useful first step in improving reliability in contemplative science generally.
A consensus is emerging that long-standing and evidenced problems in mindfulness research are linked to both theoretical and methodological issues, put simply what mindfulness is and how it can be understood. The authors argue that establishing an integrative theoretical framework will offer meditation scientists the tools to deliver more stable and comparable findings. Thus supporting the reliability of individual experiments and presenting greater opportunities for replication. It’s contended that by utilising the psychological constructs of attention, intention and awareness a contemplative cognitive framework (CCF) can be constructed, which would deliver an overarching view of the impact of meditation practice. Grossenbacher and Quaglia state that the CCF could
overcome discrepancies in mindfulness research (a very bold claim)
consider motivational and contextual aspects of meditation practice
create greater opportunities for epistemological plurality
deliver a common operational language, benefitting meditation and mindfulness research in general
Although falling short of a systematic review, the authors offered some welcome clarity in understanding the current limitations in this field. In addition, their discussion of the pressing need to consider the effect of motivation and context in meditation practice is particularly timely. The paper provides an exposition of attention and intention in a clear and informed manner. And I’d recommend this study to anyone wanting to know more about metacognition and meditation practice.
However one of the problems with meditation research, in general, is the failure to study traditional forms of meditation with a clear understanding of their ontologies and epistemologies. Any contemporary methods which claim a theoretical relationship with traditional practices, must include a credible understanding of what the original practices are. Only then can the modern translated meditation methods be scientifically framed, by understanding which operational components have been added or taken away. Without a clear awareness of what the original practice was, trying to reverse engineer a theoretical framework would appear to be a challenging process. Until we have a reliable phenomenological understanding of the traits practitioners cultivate in traditional mindfulness, a contemporary theoretical framework necessitates a degree of guesswork, even with the support of neural correlates.
The CCF may prove to offer a useful toolkit for new forms of meditation, unrelated to and independent from traditional methods. In could allow for hypotheses to be created and tested. But without greater certainty of the operational components of traditional practices, discussions regarding the metacognition of Buddhist or Buddhist inspired meditation is perhaps premature.
Grossenbacher, P. G., & Quaglia, J. T. (2017). Contemplative cognition: A more integrative framework for advancing mindfulness and meditation research. Mindfulness, 8(6), 1580-1593.
Earlier this year Plos One took the step of retracting a well known and widely cited mindfulness related study.
This particular study is a first for the Science of Meditation blog. Whilst we have featured a number of papers that have highlighted methodological problems in meditation and mindfulness research, this is the first time that we have drawn attention to a retraction of a peer-reviewed study.
The basis for the retraction is outlined in detail on the Plos One website, but we have paraphrased the three main points.
The handling Academic Editor shared an affiliation with three of the authors, although this didn’t emerge until post-publication.
Two of the authors hold or had held positions at an institute offering mindfulness related products and services in clinical contexts.
The paper has a number of errors including pooling of results which led to double counting and incorrect effect estimates in figures contained in the study.
There’s not a lot more we need to add to the identified issues, they speak for themselves. However, when considered as part of the ongoing crisis in mindfulness research they make troubling reading.
A general defence used in cognitive psychology when the findings of mindfulness studies are criticised is, the peer review system is self-regulating. That when studies are found to be below the expected standard, they are usually rejected during review. Or at the very least other experts working in the field have the opportunity to raise concerns in print. This retraction challenges this basic notion. Significant issues with both the methodology and the editorial process can endure, thus, have the ability to influence the scientific and popular understanding of mindfulness. According to Google Scholar, this Gotink et al. study has been cited over 400 times, the citing publications, in turn, used by thousands more papers. The details provided on the Plos One website indicate the study has received 50,000 views.
Rather than simply criticize this study or the journal, I would like to ask what this retraction show us about the way that meditation technologies are being treated by clinical and scientific institutions?
Authors: Gotink, R. A., Chu, P., Busschbach, J. J., Benson, H., Fricchione, G. L., & Hunink, M. M.
Title: Standardised mindfulness-based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs
Summary: This is a research paper that (at the time of writing) had been retracted by PLOS ONE.
“In light of the methodological issue and concerns about the validity of the study’s results, the PLOS ONE Editors retract this article. We regret that these issues were not fully addressed prior to the article’s publication.”
An extensive explanation of the reasons behind the retraction are published on the Plos One website which can be reached by following the link below.
New research suggests that compassion and empathy
meditation and mindfulness may be able to increase prosocial emotions and behaviour.
Authors: Luberto, C. M., Shinday, N., Song, R., Philpotts, L. L., Park, E. R., Fricchione, G. L., & Yeh, G. Y.
Title: A Systematic Review and Meta-analysis of the Effects of Meditation on Empathy, Compassion and Prosocial Behaviors
Summary: Contemplative scientists may be aware of several recent meta-studies that have challenged the methodology and theoretical frameworks of meditation and mindfulness research. However a review by Luberto et al. recently found that compassionate and loving-kindness practices can positively influence prosocial emotions and behaviours. The key finding was that in the 26 reviewed studies, meditation was linked to a positive effect on self-reported and observed prosocial measures. Although this meta-study bucks the recent trend it should be noted that many of the known problems highlighted in earlier strategic reviews (methodological flaws, reliance on waiting list or no treatment control groups, weak theoretical frameworks) have not been fully addressed.
There is a growing understanding that repeated novel behaviours such as meditation training in meditation naive participants are correlated to new or adapted neural function and structure. This then places a much greater emphasis on using a meaningful control intervention from which to evaluate the effects of meditation training. The idea that compassion or empathy based meditation can increase prosocial feelings or behaviours when compared to ‘no intervention’ reflects an underlying weakness in meditation research generally. Comparing a meditation intervention to ‘no intervention’ offers us limited insight into the potential clinical value of a meditation technology. This synthesis included 15 waiting list or no intervention control group studies among the 26 featured experiments. But it should be stressed that significant results were found in studies using both passive and active control group interventions.
The paper included a Risk of Bias Assessment, a welcome inclusion given recent findings of the failure of scientific objectivity in some meditation and mindfulness research. Luberto and colleagues established the risk of bias using the Cochrane Collaboration guidelines. They reported that 11 of the 26 studies had a low risk of bias, 12 offered a medium risk with just 3 demonstrating a high risk. Eight potential domains for bias were evaluated for each of the reviewed studies, where the risk of bias in any of the domains could not be established a rating of ‘unclear’ for that domain was recorded. It should be noted that every study had a rating of ‘high’ or ‘unclear’ in at least one domain and the mean number of ‘unclear’ ratings was 40% of the total possible. Further, that in the risk evaluation of the 8 domains for each of the 26 studies (208 potential ratings in total), none were regarded as offering a medium risk of bias. Although I am unfamiliar with this approach to evaluating bias it would appear that an absence of data indicating potential bias in any domain is discounted from the overall classification. So individual studies with unclear data regarding potential for bias in areas such as blinding, incomplete results or selective reporting could still receive a low risk of bias rating!
“Is the absence of clear data masking real world risks of bias in meditation research?”
Stephen Gene Morris
Following a traditional approach, 26 papers with a total of 1714 participants were identified from academic and scientific databases. A selection criterion was used to deliver randomized controlled studies in a range of populations who were trained in loving-kindness or compassion meditation. Results for self-reported and observable outcomes indicated significant small to medium effects. Of note is that “subgroup analyses also supported small to medium effects of meditation even when compared to active control groups”. The study also contained insights into potential physiological and neural mechanisms linked to the meditation training. Limitations of this review included the wide range of meditation methods encompassed and the variable lengths, intensities and modes of training undertaken by the respective participants.
Within this paper (and much of the available research) definitions of compassion appear to be fluid. Put simply there are few signs that contemplative science draws upon authoritative definitions of compassion either in the meditation methods used or in establishing the effect of the training. There also appears to be potential for a disconnection between the concepts integrated into the meditation methods and the instruments designed to measure compassion and empathy. Whilst the data presented offers a cautiously optimistic picture of the potential of meditation to improve positive prosocial emotions and behaviours, established concerns over methodology and theoretical frameworks remain unresolved.
Strategic reviews are challenging the popular perception of the beneficial effects of mindfulness
How far can we trust meditation research?
No matter how I tried to write the headline it came out as provocative. My intention wasn’t to be controversial, rather I wanted to articulate concerns that have been rumbling around the science of meditation and mindfulness for decades. At the heart of this story are two important yet unresolved issues. Firstly how does psychology and neuroscience understand meditation and what do the results of meditation research really mean?
The limited prosocial effects of meditation is a recent systematic review of research undertaken by Ute Kreplin, Miguel Farias and Inti Brazil. The study has been discussed in the meditation community at some length so I’m not going to review it here. But to summarize, the positive effects of meditation on prosocial behaviours (compassion, empathy, aggression, connectedness and prejudice) in healthy adults were only observed in compassion and empathy scores. However increases to compassion were just seen when the meditation teacher was one of the co-authors of the research paper or when the study used a ‘passive’ control group (this means the control group were on a waiting list). These findings are suggestive of flaws and possibly ‘bias’ in some of those studies that demonstrated significant results. In an interview with Ute Kreplin published in the international Buddhist journal Tricycle, a number of broader issues have been highlighted, it’s those that I’d like to push around a little now. Leaving to one side the methodological flaws which are the main focus of the Tricycle interview, let me draw attention to the potential causes of the ongoing limitations in our attempts to evidence the effects of meditation.
It should be stressed that the Kreplin, Farias and Brazil paper is one of a number of reviews that came to similar conclusions, that many (possibly most) of the published studies reporting significant effects in non clinical populations had methodological and/or theoretical flaws. And as Kreplin hinted, published research tends only to be the tip of the iceberg, studies that fail to show measurable changes in meditators rarely see the light of day. So the examples analyzed in strategic reviews are not the full picture of meditation research, they offer a very selective (positive) account of the scientific landscape. And yet the common perception grows that meditation is a panacea able to deliver a range of desirable outcomes to almost anyone willing to practice a method.
“At this moment in time the science generally isn’t helping us to understand the benefits of meditation…”
Stephen Gene Morris
By way of transparency I should make it clear that I’m an experienced meditator and confident of the great benefits of the practice. My interest in contemplative science comes from the perspectives of both a trained cognitive psychologist and a practicing Buddhist. From my experience of teaching traditional meditation systems, it is unrealistic to claim that a few weeks of meditation practice automatically leads to ‘significant’ change. Some practitioners do progress rapidly, embracing the transformative potential of meditation, but others fall away after only a few weeks, sometimes disillusioned and unfulfilled. This is a difficult subject to address coming from a traditional meditation perspective, because judging or criticizing the progress of another practitioner is something of a taboo. But to enhance the wider understanding of meditation this point needs to be stressed. There is no reason to assume that the meditation method alone leads to change, the method is an integral part of a firmly established theoretical framework. The effects of meditation tend to be meditated by several factors such as, individual capacity, participant motivation and qualitative differences between the teacher or teaching systems.
The contemporary scientific investigation of meditation typically takes the reductionist approach, stripping out components that might confound the results of an experiment, such as variability in the method or differences in the environment. But isolating the cause (meditation method) and the effect (empirical change in the participant) is difficult, and in complex aspects of human behaviour such as empathy or compassion it may be beyond the scope of many experiments. Consider that large numbers of the participants in meditation studies are likely to be undergraduates ‘pressed’ into research projects, obliged to participate in return for course credits. If meditation doesn’t always work for the people who choose to attend classes in the wider community why should things be any different in an experimental setting?
The ‘expectation’ that a meditation method in itself leads to change is not supported by the human history. This idea may eventually be confirmed by science but the data gathered so far is inconclusive. We know that a number of meditation scientists are committed practitioners, so perhaps they have first hand experience of the benefits of meditation or mindfulness. Is this as Kreplin suggests, part of the problem? Could the experiential knowledge of the results of meditating introduce subconscious bias into research methodology? I’m a meditator I know about the benefits of regular practice but I can see dangers to the credibility of meditation systems if claims based on poor science are over-hyped. The lack of long term studies for secular forms of meditation should also be a serious concern.
The failure to establish robust findings in meditation research begs a further question, without reliable replicated science how does the delivery of meditation technologies continue to grow in society? If scientists are raising questions about the claims made in individual studies why isn’t this filtering down more into health care, public policy and the media? If meditation and mindfulness interventions cannot be shown to work, or deliver predictable results, confidence in meditation generally may decline. It might also lead to an erosion in the status of experimental psychology as a provider of independent and reliable data.
These few paragraphs are simply an introduction to the subject, the start of a very long road. It can be argued that the contemporary western scientific investigation of meditation began in the 1970s, since when perhaps as many as 10,000 studies have been published. But based on the findings from recent strategic reviews our scientific understanding of meditation is at a surprisingly preliminary stage.
The Kreplin, Farias and Brazil study can be found here.
The first episode of NDA offers an introduction into duality and non duality. It’s nice, easy to follow and uses everyday examples that makes the subject very approachable.
The first episode of NDA offers an introduction into duality and non duality. It’s informative, easy to follow and uses everyday examples that makes the subject very approachable. To sign up to the podcast visit the feed here.