Does meditation change our emotions?

New research suggests that compassion and empathy
meditation and mindfulness may be able to increase prosocial emotions and behaviour.

What effect does compassionate meditation have on prosocial behaviour?
What effect does compassionate meditation have on prosocial behaviour?

Authors: Luberto, C. M., Shinday, N., Song, R., Philpotts, L. L., Park, E. R., Fricchione, G. L., & Yeh, G. Y.

Year: 2018

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.

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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.

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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.

Link:  www.researchgate.net

How far can we trust meditation research?

Strategic reviews are challenging the popular perception of the beneficial effects of mindfulness

How far can we trust meditation research?
Looking for answers from meditation?

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.

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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?

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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.

Notes

The Kreplin, Farias and Brazil study can be found here.

Compassionate meditation creates a positive outlook

Train in compassion to create a more positive outlook.

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Regular compassion-based meditation linked to positive and caring thoughts

Authors: Jazaieri, H., Lee, I. A., McGonigal, K., Jinpa, T., Doty, J. R., Gross, J. J., & Goldin, P. R.

Year: 2016

Title: A wandering mind is a less caring mind: Daily experience sampling during compassion meditation training.

Summary: The concept of mind wandering is well known to all of us. It’s the kind of drifting off that we experience when we are not concentrating on a specific activity or goal, people also call it daydreaming or spontaneous thought. If we have a challenging task that requires our full attention we tend to do little or no mind wandering, and conversely, when we are mind wandering we are much less able to concentrate on a task. The two neural networks responsible for task functions and mind wandering respectively are thought to be negatively correlated, when one is more active the other in more passive and vice versa. The benefits of better concentration and task performance are obvious, but we are starting to see that mind wandering may also have a key role to play in our health and wellbeing. This study is one of the few investigations into meditation that acknowledges that mind wandering may have a positive role to play in our lives.

This study investigated the effects of nine weeks of compassion training on 51 adults. As part of my own research into meditation and mind wandering, I have revisited the paper. There are two conclusions that I’d like to draw your attention to. Firstly that the meditation was linked to a decline in mind wandering to neutral topics but an increase towards pleasant topics. That meditation can lead to decreased mind wandering is well known, the highlight of this study is that meditation seemed to change the type of mind wandering. This is highly suggestive that mind wandering has both a qualitative and quantitative aspect. That some forms of mind wandering might actually be beneficial in some way, therefore suppressing mind wandering generally might not of itself be a useful target of any wellbeing intervention.

The evidence that compassionate meditation can naturally draw the mind away from the negative and towards the positive could have profound implications for our health. Mind wandering is spontaneous, it’s not consciously constructed if compassionate meditation leads to a natural increase in positive thoughts, it indicates an association with a range of other cognitive processes. This view is supported by a second finding from the research, that compassionate meditation is linked to augmentation in caring behaviours for oneself and others.

Link:  www.tandfonline.com

 

Does cognitively-based compassion training (CBCT) beat depression?

Does compassion training lead to a lowering in self reported depression? This experiment involving second year medical students suggests it might.

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Authors: Mascaro, J. S., Kelley, S., Darcher, A., Negi, L. T., Worthman, C., Miller, A., & Raison.

Year: 2018

Title: Meditation buffers medical student compassion from the deleterious effects of depression

Summary: It’s no surprise to hear that the pressure from exams, and academic life in general, puts students under pressure, subjecting them to the effects of stress. This is a particular problem for medical students, given that compassion and attention to patient wellbeing are central to their professional development. Not only that but in professional practice, clinical staff may be frequently subject to the suffering of others. In an effort to study these and other issues, an experiment was undertaken to see if a course of Cognitively-Based Compassion Training (CBCT) could be integrated into the curriculum of medical students in their second year of study. A second objective was to explore the effects of CBCT on the day to day functioning of the students, specifically looking at the ability of the intervention to raise compassion scores while lowering depression levels.

In a randomized, single-blind, wait-list controlled study, the students that were provided with CBCT saw an increase in compassion and a decrease in depression compared to control. Those students that had the highest self-reported levels of depression at the start of the experiment saw the most benefit from the intervention in terms of reduction to depression scores.

Link: https://www.tandfonline.com

Compassion and palliative care

Compassionate, loving kindness and mindfulness interventions in a palliative care setting.

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Authors: Claudia Orellana-Rios, Lukas Radbruch, Martina Kern, Yesche Regel, Andreas Anton, Shane Sinclair and Stefan Schmidt

Year: 2017

Title: Mindfulness and compassion-oriented practices at work reduce distress and enhance self-care of palliative care teams: a mixed-method evaluation of an “on the job“ program

Summary: Notwithstanding the extensive body of work exploring meditation and mindfulness, there is a shortage of studies that address the potential of compassion based interventions in the workplace. A national survey of palliative care practitioners had established that for 42% of respondents, frequent patient deaths was a challenging aspect of their work. Although many people report beneficial effects from delivering compassionate care, extensive exposure to suffering can be a problem for workers. This investigation recruited participants from a palliative care centre in Bonn, Germany.  Ten weeks of training in meditation combining a number of elements including, mindfulness, loving kindness and tong-len was provided. A range of mixed measures was used to establish the benefits of the practice including, a battery of self-reporting questionnaires, semi-structured interviews and a physiological measure. In conclusion, no evidence that participants experienced an increase in compassion was observed. However, improvements were reported by participants in areas including self-care and emotional regulation. The was no significant change to the cortisol levels taken as part of the trial.

Given the complex nature of introducing compassion into this particular work environment, the mixed method approach should be commended. Where compassion, loving-kindness and mindfulness are brought together as an ‘omnibus’ approach, a degree of epistemological plurality is likely to be required to gain a full understanding of the results. Reliably evaluating the effects of one approach (such as compassion) in such a trial can be a challenge in itself. However to integrate three approaches (mindfulness, compassion and loving-kindness) into a working environment, then to understand their effect individually and collectively, is making great demands of the self-reporting instruments.

It should be noted that in a recent meta-study investigating the pro-social effects of meditation, the teaching of the meditation practice by a co-author of the research was seen to be an influential factor. The precise nature of the meditation taught in this case is unclear and may, to some extent, be related to the individual approach of the teacher. The assumption that different kinds of meditation, such as compassion (tong-len), all fit within an easily replicated framework is perhaps the result of the theoretical uncertainty withing psychology towards contemplative science. There is still a shortage of data exploring how interrelated constructs such as loving-kindness and compassion might influence behaviour in the workplace. In this regard, the study provides useful information that may help the understanding of these constructs in particular working environments.

Link: https://bmcpalliatcare.biomedcentral.com

Methodological problems in mindfulness research

Problems in how meditation is researched are highlighted in this meta study. But the paper stops short of explaining why its lost in a ‘theoretical mist’.

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Authors: Ute Kreplin, Miguel Farias & Inti A. Brazil

Year: 2017 (print), 2018 (online)

Title: The limited prosocial effects of meditation: A systematic review and meta-analysis

Summary: This systematic meta-review explored the effects of meditation and mindfulness on five types of pro-social behaviour (compassion, empathy, aggression, connectedness and prejudice). The study contended that although there was evidence that compassion and empathy were mediated by meditation, the other three factors were not. Further, that compassion levels were found only to increase when a co-author of the study was the meditation teacher or when the control group was a passive (not active) waiting list. The study highlighted a number of key problems in the ongoing study of meditation, particularly the consistent application of appropriate methodologies.

However, weaknesses in the scientific investigation of meditation tend to be linked to the absence of robust theoretical frameworks. For example inconsistent definitions of mindfulness and meditation. Meta-studies in this field can reflect wider patterns but risk drawing together forms of meditation that may in effect, be quite different. The authors are correct to highlight the ‘theoretical mist’ surrounding meditation research and the failure of science to treat meditation as either a secular or spiritual practice. But despite citing architects and theorists of contemporary meditation, the authors fall short of explaining how the pseudo-spirituality of contemporary secular meditation arose or is being sustained.

Link: https://www.nature.com/articles/s41598-018-20299-z

Compassion, meditation and depression

Can cognitive based compassion therapy (CBCT) help with depression?

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Authors: Jennifer S. Mascaro,  Sean Kelley, Alana Darcher, Lobsang Tenzin Negi, Carol Worthman, Andrew Miller, Charles Raison

Year: 2018

Title: Meditation buffers medical student compassion from the deleterious effects of depression

Summary: The body of evidence demonstrating that compassion training offers significant benefit to its practitioners (and the wider community) is growing.  This particular study investigated cognitive-based compassion training’s (CBCT) relationship to the wellbeing of medical students in their second year of training. Compassion is a particularly important issue for people working in clinical settings. Because of the nature of their activity, a degree of compassion is desirable if not essential. However, there is concern over issues connected to ‘compassion fatigue and ‘burn out’. A total of 59 students engaged in the research, those participants that received CBCT reported increased compassion and decreased loneliness and depression.

Perspective: Contemplative science, health psychology

Link:  http://www.tandfonline.com/doi/abs/10.1080/17439760.2016.1233348