Meditation, poverty and mental health; psychology and nonduality

We know that poverty can make poor mental health more likely. But therapeutic interventions rarely consider the root causes of mental illness. Could nondual treatments be a solution?

Poverty is a factor in poor mental health

The BPS’s project to support people move from poverty to flourishing has highlighted several important issues; among the most challenging is the notion that mental health is not a ‘DIY project’.1 The challenge arises because, in psychology, there are technical and conceptual barriers to considering social factors such as community and institutional engagement in clinical intervention. However, the social networks that mediate mental wellbeing are becoming even more critical in the COVID and post-COVID worlds.2 Positive social interaction is foundational to health and wellbeing, but many clinical interventions fail to integrate biopsychosocial models into diagnosis and treatment. And the reductive nature of experimental psychology places barriers to considering the individual and the social concurrently. Understanding the personal cost of poverty requires a wide lens; mental suffering doesn’t exist in isolation to family, community or institutions.3 Integrating and tackling mental health’s inner and outer determinants is central to countering the psychological damage caused by enduring poverty. This article will discuss how compassion mind training (meditation) can address mental suffering while encouraging supportive social networks. I’m also going to argue that to access the full potential of compassion mind training, new psychological approaches to meditation are required.

Although there are challenges to defining compassion, the wish and/or the action to alleviate suffering is an acceptable description for many working in the field. Therefore, it is not controversial to argue that a more compassionate society would reduce suffering. There is also evidence that more compassionate individuals suffer less. Although an oversimplification, it’s worth pausing on the notion that compassion interventions can support individual psychological wellbeing and the social factors able to mediate mental health. The consideration of clinical interventions linked to broader social settings is unusual for many psychologists, certainly those working in experimental settings. But understanding how poverty affects a person within their environment is a priority. Without attention to the root causes of mental suffering, psychological interventions will only have a modest impact. I’m not talking about social policy here (in any direct sense); instead, I’m suggesting that more attention needs to be given to curative approaches that address both the internal (mental) and external (social) causes of suffering. Over the last two decades, the growth in compassion research has emerged from the project to medicalise spiritual meditation. But few of the 7,000 meditation studies published over the previous eight decades address the biopsychosocial potential of meditation. Ironically, this holistic and now neglected aspect of traditional meditation was critical to the initial academic and scientific interest.

The reasons for reluctance to consider social factors, alongside mental health treatment, are typically linked to preserving the integrity of the experimental method. Controlling potential confounding variables has always been a central goal of experimental psychology. But compassion mind training highlights that mental states are influenced by cognitive processes based on our inner and outer worlds. Medicalised meditation is one area of research and practice where therapy considers both the psychological and the social. Over the last twenty years, compassion mind training has been shown to improve, physical and mental health as well as social relationships. In their 2017 meta-review of published compassion studies, James Kirby, Cassandra Tellegen and Stanley Steindl concluded that compassion interventions held ‘promising’ potential to reduce suffering from depression, anxiety, and psychological distress.4 Two of the leading advocates for the use of compassion training are Paul Gilbert and James Doty. Paul Gilbert OBE is the founder of Compassionate Mind Training (CMT) and  Compassion Focussed Therapy (CFT), Dr Doty has been the driving force behind Stanford’s Center for Compassion and Altruism Research and Education (CCARE). Between them, Doty and Gilbert have highlighted how compassion mind training can support individual and collective mental health. Gilbert’s 2019 exploration into the nature and function of compassion sets out current research and practice.5 Particularly relevant here is the notion of compassion as a ‘social mentality’. In this context, social mentality refers to the creation of relationships. Although this concept falls far short of the use of compassion in spiritual meditation, it signposts new opportunities for scientific understanding.

A multi-directional view of compassion allows a relationship of mutual support between the psychologist and the patient to develop. In this scenario, peers come together to solve problems; hierarchical limitations are less pronounced. Gilbert uses the primary caregiver-child relationship as an example of this reciprocity, but this illustration is most useful as a heuristic to think about compassion in new ways. Rather than the passive recipient of therapy, the patient also becomes a catalyst for compassionate thoughts towards others. Mind training in compassion can be, as Gilbert describes, a dynamic process between patient and clinician, but it is not necessarily limited to that. Compassion can support the mental health of the patient while also developing their compassionate insights towards society more generally, and thus stimulating increased social engagement. The research agenda of CCARE includes investigation of ‘methods for cultivating compassion and promoting altruism within individuals and society-wide’.6 These are the nondual insights that highlight the potential of mind training to support mutually dependent relationships between community and self.

Despite pioneers such as Gilbert and Doty, compassion research appears to be developing the same limitations as other forms of medicalised meditation. Construct validity is still uncertain, and reliable psychometric instruments are a work in progress. And if you follow the literature, you will find frequent overlaps between compassion and concepts such as empathy, altruism and loving-kindness. Attempts to reduce the idea of compassion by establishing the binary constructs of self-compassion and other-compassion have also run into difficulty; in 2017 Christian Kandler and his colleagues demonstrated that self-compassion is a facet of neuroticism.7 From a historical perspective, several common problems are visible in the relocation of meditation to psychology. For example, similar methodological and theoretical limitations exist in the research of mindfulness, compassion and related pro-social behaviours.8 While it might be premature to suggest the scientific study of meditation in its current form (and therefore compassion mind training) has reached an impasse; clearly, there are obstacles to making further progress. The scientific study of meditation technologies is rich with intersections between traditional spiritual practice and psychology. For example, Doty and Gilbert both draw heavily on Tibetan Buddhist influences in their work. But while psychology can safely observe the effects of traditional meditation from a scientific perspective, integrating practices from spiritual traditions with psychology is a risky undertaking. Risky on several levels, but primarily because of the conflict between the world views of Western science and Eastern knowledge systems.

The migration of traditional meditation from the temple to the laboratory followed a long and complicated path. Many of the problems and opportunities for meditation-based mind training come into sharper focus when we consider meditation’s scientific history. From the early engagements, western scholars and scientists have been working on two broad trajectories to medicalise Eastern mind training methods. The paths of integration and appropriation. The integration path can be traced back through the medical counter-culture, Zen psychotherapy and Buddhist reform movements of the late 19th century. Experimental work with electroencephalographic (EEG) technologies from the 1930s laid the foundations of the path of appropriation. The rise of scientist-practitioners since the 1970s, people such as Robert Wallace and Jon Kabat-Zinn, accelerated spiritual and psychological convergence. In both interconnected strands, foundational cognitive elements of traditional meditation, such as ethical judgement and compassion, were uncoupled from modern medicalised methods. These ‘human’ factors give spiritual meditation holistic curative potential through the interconnectivity between self and others. Richard King and Steven Stanley are just two of the academics that highlight the loss of these elements during meditation’s relocation. In scientific investigations of mind training’s operational features, I have found no comparative studies that evaluate traditional meditation methods with reference to their ontological frameworks. This inevitably means that we have uncoupled compassionate mind training practices, by accident or design, from their original conceptual contexts. This same point applies to mindfulness meditation.

There is no question of normativity here or comparative judgement of the psychological methods over spiritual practices (or vice-versa). The issue under discussion is, how can compassion mind training be best used to support people from poverty to flourishing? Despite a lack of replication, the cumulative evidence for the benefits of compassion methods is significant. However, in common with mindfulness, compassion meditation remains a ‘promising’ rather than an effective mental health intervention. We should not underestimate the impressive progress made in this field, particularly since the 1970s. But the challenges presented by increasing levels of poverty require more reliable and flexible meditation-based interventions. In order to harness the full potential of compassion mind training, two questions need to be addressed; what happens to traditional meditation methods translated to psychological interventions, and what is lost or gained in the process?

Even a preliminary investigation of Buddhist (Mahayana) ‘science and philosophy’ reveals foundational concepts underpinning meditation methods such as ‘relative compassion’, ‘nonduality’ and ’emptiness’. But acknowledgement of these elements in traditional meditation is almost totally absent from the psychological literature. It is problematic to relocate human technologies to new knowledge systems without understanding the original cognitive components. This is an approach that risks creating interpretive forms that lack essential elements. The uncoupling of meditation from its full potential during the migratory process probably explains the perennial ‘promising’ tag that has followed the clinical use of meditation for fifty years. New translated forms of mind training could develop into effective Westernised psychological interventions in their own right. But taking the historical perspective, I’d ask how long will it take and how useful will they be? The pressing challenge of tackling the suffering linked to poverty requires new approaches to develop our current knowledge.

Perhaps the most significant limitation in the project to medicalise meditation is the failure to find a common language for psychology to engage with the traditional forms of meditation. There is a need for a lingua franca, a conceptual rosetta stone that will allow psychologists to access the curative potential of compassion long observed in Buddhist meditation. Doty, Gilbert and others frequently hint at this potential but generally retreat into positivist terminology to investigate and describe it. The role of meditation in supporting mental health and social networks remains largely theoretical or anecdotal to psychology. The shortfall between what medicalised meditation is and what it could become appears to be brought about by inflexible approaches to non-Western knowledge systems; a tendency to translate human technologies ahead of the full documentation of psychological benefits. The scientific history of meditation indicates that psychology requires more sophisticated ways of understanding the world if it wishes to unlock mind training’s full potential. While positivism is a powerful investigative tool, its current form appears unable to penetrate aspects of traditional (non-positivist/nondual) knowledge systems. Given the growing role of meditation technologies in society, the creation of a new discipline to access traditional knowledge is long overdue. The development of nondual psychology would create an approach able to consider the curative potential of traditional compassion meditation (and its operational cognitive components) free of the distortions of cultural and ontological translation.

Notes


1 ‘From Poverty to Flourishing: Towards 2021 | The Psychologist’ https://thepsychologist.bps.org.uk/volume-33/october-2020/poverty-flourishing-towards-2021.

2 Ichiro Kawachi and Lisa F Berkman, Social Ties and Mental Health, Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2001, lxxviii.

3 ‘WHO | Social Determinants of Mental Health’, WHO, 2019 http://www.who.int/mental_health/publications/gulbenkian_paper_social_determinants_of_mental_health/en/ [accessed 4 January 2021].

4 James N Kirby, Cassandra L Tellegen, and Stanley R Steindl, A Meta-Analysis of Compassion-Based Interventions: Current State of Knowledge and Future Directions, 2017 <www.elsevier.com/locate/bt>.

5 Paul Gilbert, ‘Explorations into the Nature and Function of Compassion’, Current Opinion in Psychology (Elsevier B.V., 2019), 108–14 https://doi.org/10.1016/j.copsyc.2018.12.002.

6 Mission & Vision – The Center for Compassion and Altruism Research and Education’ http://ccare.stanford.edu/about/mission-vision [accessed 4 January 2021].

7 Christian Kandler and others, ‘Old Wine in New Bottles? The Case of Self–Compassion and Neuroticism’, European Journal of Personality, 31.2 (2017), 160–69 https://doi.org/10.1002/per.2097.

[8] Nicholas T. Van Dam and others, ‘Mind the Hype: A Critical Evaluation and Prescriptive Agenda for Research on Mindfulness and Meditation’, Perspectives on Psychological Science, 13.1 (2018), 36–61 https://doi.org/10.1177/1745691617709589.

Compassionate meditation from a scientific perspective

A review of the origins of compassion and the benefits of compassionate mind training. from spiritual and scientific perspectives

Compassion, the wish that other be free from suffering and the causes of suffering

Author: Paul Gilbert

Year: 2019

Title: Explorations into the nature and function of compassion

Summary: Paul Gilbert has been researching and writing about compassion for much of his career. In this paper from 2019, Gilbert offers a general introduction to current thinking and research in the field. The article doesn’t concentrate on scientific evidence from a cognitive or neuropsychological perspective, although there are some useful citations. In the opening definitions of compassion, potential evolutionary origins discussed, highlighting the foundational influence of ‘mammalian caregiving’. According to this model, it is the caregiving instinct of mammals that eventually gives way to more complex processes leading to the forms of compassion that we recognise in human behaviour. In describing compassion used in spiritual traditions, Gilbert signposts approaches from Buddhism and Jainism. And in an attempt to homogenise definitions from East and West, he offers us his synthesis of explanations from different knowledge traditions. There is a discussion of clinical and experimental progress in the field, focussing on both medicalised and Buddhist compassion training methods. In conclusion, Gilbert makes the case that compassion is an inherent trait that can be developed through training and motivation.  

Compassion (and compassionate values and moral) is not just automatic but something that can be deliberately chosen and worked at with a deepening of understanding over time.

Discussion: I want to acknowledge that Gilbert has made significant contributions to the western positivist understanding of the construct of compassion. This paper describes some complex ideas simply and at times, elegantly. But the overall impression is the presentation of the author’s particular perspective, a notion supported by a lack of critical insight. Citations of recent scientific studies are grouped logically, but I would have also valued some expert guidance on theoretical or methodological limitations in these papers. As a general principle, I find the use of evolutionary psychology to support definitions of complex human behaviours speculative, so it is perhaps unsurprising I wasn’t convinced by the accounts of the origins of compassion. The conclusions do offer a helpful overview of the subject, particularly to people new to this area. However, my central reservation was the selective use of concepts from different knowledge systems, particularly as the paper makes universal and generalised claims.

It is legitimate to draw on illustrations from Eastern spiritual tradition, but appropriate contextualisation is essential. So, for example, the discussion of Mahayana Buddhist concepts of compassion indicates that there are different understandings in Buddhism. These contrasting positions in Buddhism are supported by alternative ontological and epistemological frameworks that underpin interpretations of compassion, meditation and mind-training. I accept that this is a complex area, but if we fail to consider human understanding in its relevant context, we risk defining universal human traits and states from a narrow Western positive perspective. And in doing so, essential psychological constructs known and evidenced in traditional knowledge systems, such as non-dual compassion and relative compassion, will continue to be excluded from scientific study and consideration.

Link: https://www.sciencedirect.com

How to protect your mental health during the time of Covid-19

If you’re worried about covid19, self isolation or your future generally, there are actions you can take to reduce fear and anxiety.

purple flower field during sunset
Covid-19 is a significant problem, but fear is the real enemy

At the start of any discussion about suffering, and this definitely includes fear, I like to stress that the information I provide is focussed on solutions. The objective of this article is to highlight ways of decreasing fear and improving health and wellbeing.

Underestimating Coronavirus is not an option, and it’s not the object of this short discussion of fear and mental health. But the reality is that each of us will face challenges during our lives. This is part of the nature of being human, to overcome obstacles. And while we know that Covid-19 is putting peoples lives at risk, it is just one of many dangers we face. However, both modern psychological medicine and traditional understandings of the human experience agree that disproportionate fear is a cause of suffering.

Threats exist, to be aware of potential risks and to take appropriate preventative action is both reasonable and desirable. However, awareness of risk is not the same thing as fear of the threat. Fear is largely an emotional response that each of us has some control over. While most of us manage anxiety well, there may be times when it can overwhelm us. If we experience sustained periods of acute fear, it is likely to have a detrimental impact on our physical and mental health. What’s important to recognise is that much of the anxiety we experience is under our control.

man wearing a black face mask

The way we think has a direct effect on our emotions. While we often claim that ‘you make me angry’ or ‘this song makes me sad’, the reality is, we are choosing to feel angry or sad. It is usually our reaction to what happens that creates our sense of happiness or sadness. This is as true of Coronavirus as any other perceived danger. At the time of writing, we face health risks from Covid-19, instability in the employment and financial markets and many other related problems. But these are not the cause of fear in a strictly scientific sense, it is our reaction to events that rests at the heart of how we experience life. It has been said that fear is healthy, it keeps us alive. While this might be true in rare examples (popular psychology often talks about our fight or flight mechanism), this visceral fear manifests in the form of a reflex and requires little conscious thought. However, the rumination about a threat is an entirely different matter, humans can turn relatively benign concerns into the source of prolonged stress and anxiety.

“Compassion training is the most important support to my health and wellbeing, it has given me improved mental health, greater resilliance and a good deal of happiness. “

  Stephen Gene Morris

So what does all this mean for our health during the current challenging times? It goes without saying that we should take sensible precautions. But, we should pay attention to the way we think about risk. Too much fear will affect our health and reduce our ability to make rational choices. A number of nonrandomised studies indicate that compassionate practices may be useful in combatting fear-related conditions such as anxiety disorders, depression and posttraumatic stress disorder.1 In this regard, compassionate meditation may be a helpful tool to combat fear. Nondual forms may be particularly important to maintain a proportionate sense of ‘self and other’, particularly in lockdown and social isolation.

So the take-home points; take Covid-19 seriously but know that compassionate practices can build resilience to fear and anxiety.

 

Notes

1 Graser, J., & Stangier, U. (2018). Compassion and loving-kindness meditation: an overview and prospects for the application in clinical samples. Harvard review of psychiatry, 26(4), 201-215.

Does meditation change our emotions?

New research suggests that compassion and empathy-based 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.

adult anger art black background

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.

adult bracelets colors fingers

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.

woman meditating

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 practising 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?

ancient architecture art asia

The ‘expectation’ that a meditation method in itself leads to change is not supported by 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.

man holding woman s hand
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