The mindfulness concept can be saved, but a major revision is needed

The latest study of mindfulness in schools found that it ‘does not improve mental health’ and is contraindicated for some students.

Everything might have an ‘effect’, but how do we evaluate it?

On Tuesday 12th of July, the Guardian published details of a scientific study that raised important questions about the use of mindfulness in secondary schools. This article discussed a My Resilience in Adolescence (Myriad) trial of the benefits of School-based mindfulness training (SBMT), a major research effort involving 8,376 students in the 11–13 age range across different sites. The study had robust clinical methodologies, and it’s perhaps the most reliable SBMT investigation published to date. However, the Guardian headline claimed that ‘SBMT does not improve mental health’. But the original paper offers even more challenging findings:

SBMT as delivered in this trial is not indicated as a universal intervention. Moreover, it may be contraindicated for students with existing/emerging mental health symptoms.

Clinical implications:

Universal SBMT is not recommended in this format in early adolescence. Future research should explore social−emotional learning programmes adapted to the unique needs of young people.1

This is not the first scientific study of SBMT; the Guardian describes earlier research as ‘mixed’. Taken together, the earlier and current findings for the benefits of SBMT reflect an established pattern in the science of mindfulness that is frequently ignored, a tension between tentative early-stage studies and more robust scientific evidence. Demonstrating positive preliminary effects has never been a problem in the scientific engagement with meditation. In the first twenty years of mindfulness research, spectacular claims were frequently made about the benefits of meditating, but few of those preliminary findings were confirmed by large-scale randomised controlled trials (RCTs).

Since the 1980s, scientists have warned that preliminary uncontrolled, unrandomised, unreplicated mindfulness studies must be treated cautiously. And strategic reviews of mindfulness research frequently found initial claims to be unreliable on both theoretical and methodological grounds. But these evidence-based problems have had little effect on the scientific and social policy enthusiasm for mindfulness. This binary of positive preliminary studies challenged by more scientifically reliable evidence continues to this day. And traces of it can be seen in other forms of medicalised meditation. The problem illustrated by this Myriad trial of SBMT is simply the latest example of the paradoxical nature of mindfulness, an intervention frequently more promising than proven. 

The rationales underpinning many mindfulness clinical studies have provoked concerns. One of the harshest from Nicholas Van Dam and 14 co-authors who, in 2018, claimed that methodological weaknesses and unreliable reporting of initial claims might lead mindfulness consumers to be harmed.2 As a meditator and meditation scientist, nobody wants to see the success of medicalised meditation methods more that I. But there is evidence that we are in an epistemological crisis in meditation research. A state confirmed by my current project to write a scientific history of mindfulness. However, rather than a simple description, my work has identified the causes of the crisis and, thus, the possible solutions. But given the current trajectory of mindfulness research, there is little hope of significant change until the mindfulness community confronts the systemic research problem in this field present since the 1980s.

Notes

  1. Montero-Marin, Jesus, Matthew Allwood, Susan Ball, Catherine Crane, Katherine De Wilde, Verena Hinze, Benjamin Jones et al. “School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial?.” Evidence-Based Mental Health (2022).
  2. Van Dam, N.T., Van Vugt, M.K., Vago, D.R., Schmalzl, L., Saron, C.D., Olendzki, A., Meissner, T., Lazar, S.W., Kerr, C.E., Gorchov, J. and Fox, K.C., 2018. Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on psychological science, 13(1), pp.36-61

Author: Stephen

Neuropsychologist researching what happens when a spiritual practice (meditation) is translated to a psychological intervention; what is lost and what is gained from the curative potential? A PhD candidate writing the scientific history mindfulness. Also researching how compassion and explicitly nondual meditation methods influence our physical and mental health. Stephen has decades of personal practice in spiritual and secular forms of meditation, he has also been trained in the Himalayan Science of Mind and Perception (Tsema). Alongside the teaching and research of nondual methods, Stephen trains his own brain every day with Dzogchen practices.

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