Evaluating the billion-dollar mindfulness experiment: promising but not proven

A new study may have discovered why, despite a huge scientific investment, mindfulness research has been problematic for decades.

Photo by Alex Azabache on Pexels.com

With the aim of bridging these two epistemologies of science and dharma, I felt impelled to point out in the early years of MBSR the obvious etymological linkage of the words medicine and meditation and articulate for medical audiences their root meanings.

Jon Kabat-Zinn1

The version of mindfulness founded by Jon Kabat-Zinn in 1979 has always been problematic to validate scientifically. Over the last forty years, scientists, clinicians and other academics have been trying to understand what mindfulness is and how it works.2 My recently published study argues that attention to Kabat-Zinn’s claims about the origins of mindfulness hold an explanation for the current research crisis.3

There is (and always has been) a paradox in the scientific understanding of mindfulness. Thousands of preliminary clinical studies claim health benefits linked to its use. At the same time, strategic scientific reviews have illustrated that many of these studies cannot be regarded as scientifically reliable. And as the research interest has grown, the mindfulness paradox has become more problematic. We may have also reached the stage where mindfulness may be considered by health and social policy as too big to fail’. Mindfulness is now a global phenomenon; there are over 30,000 published papers in academic databases. And many scientists and institutions have continued to promote the use of mindfulness despite the presence of scientific uncertainty. In financial terms, the cost of meditation and mindfulness research is estimated at over $1.6 bn. The vast majority of this investment has been made since 2012.

In financial terms, the cost of meditation and mindfulness research is estimated at over $1.6 bn. The vast majority of this investment made since 2012.

Stephen Gene Morris

Based on a three-year study of the scientific literature, I contend mindfulness can only be fully understood by looking at its origins. The paradigm established by Jon Kabat-Zinn is rooted in the medicalised meditation movement founded in 1970. And in one sense follows the trajectory of the Religion of Science, a popular philosophy in the first decade of the twentieth century. Mindfulness has been built on a belief that an ontological congruence exists between religion and science. Unpacking this claim is key to resolving the costly mindfulness paradox and charting a more scientifically reliable future.

Notes:

1. Kabat-Zinn, Jon, ‘Some Reflections on the Origins of MBSR, Skillful Means, and the Trouble with Maps’, Contemporary Buddhism, 12.1 (2011), 281–306. https://doi.org/10.1080/14639947.2011.564844

2. For an overview of the current issues, see: Van Dam, Nicholas T., Marieke K. Van Vugt, David R. Vago, Laura Schmalzl, Clifford D. Saron, Andrew Olendzki, Ted Meissner et al. “Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation.” Perspectives on psychological science 13, no. 1 (2018): 36-61. https://journals.sagepub.com/doi/abs/10.1177/1745691617709589

3. Morris, Stephen,””The Rise of Medicalised Mindfulness During the 1970s and 1980s: The Attempted Convergence of Religion and Science.” Brief Encounters 6, no. 1 (2022). http://www.briefencounters-journal.co.uk/BE/article/view/296

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The crisis in mindfulness research: have we been asking the wrong questions?

A review of mindfulness research in New Scientist highlighted long standing scientific problems; is it time for a new approach?

The crisis in mindfulness research: have we been asking the wrong questions?

How does science understand meditation
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Writing in New Scientist on June 5th Jo Marchant summarised the state of mindfulness research and practice. The investigation added some much-needed balance to the overview of medicalised mindfulness. The article confirmed the enduring presence of uncertainties in theoretical understandings and systemic methodological weaknesses. A discussion of the potentially harmful effects of meditation was especially welcome; most experienced meditation teachers know that practices can lead to beneficial or detrimental outcomes in practitioners.

However, the absence of greater historical insights left us with a snapshot rather than an overview of the current state of our scientific knowledge. For example, scientists have been criticising meditation experiments since the 1970s, but the weaknesses identified over 40 years ago can still be seen in contemporary research. The scientific study of meditation can be traced back at least 80 years; the first decades were relatively free of scientific uncertainty. By identifying the beginning of hesitancy in meditation research, we can better understand the current crisis in the science of mindfulness. Since 1975, an estimated 7,000 scientific papers investigating meditation have been published. The vast majority of this work has focussed on mindfulness, so should we be worried that we still don’t have a reliable scientific definition of it?

The evidence suggests that we (meditation scientists) have been trying to establish mindfulness’s psychological and clinical potential ahead of a stable understanding of what it is. We know from several strategic reviews that multiple ways of understanding mindfulness exist in the scientific literature. While each mindfulness experiment can offer us some new insights, findings are rarely confirmed through replication? When taking the long view of meditation research, medicalised mindfulness manifests within visible patterns of scientific progress. In its origins, medicalised meditation reflects a confluence between positivist and belief based knowledge systems. The current theoretical uncertainty in mindfulness research can be traced back to this convergence. If mindfulness has been developed as a bridge between spiritual and scientific understandings, do we have adequate ways of making sense of meditation as a human experience? The lack of stable definitions and replication suggests there are still significant gaps in our knowledge. The most pressing unanswered questions remain the most important, what is medicalised mindfulness, and how can we understand it?

Meditation, mindfulness and nonduality; an agenda for scientific change

How did a spiritual practice become a medicalised health intervention? An understanding of nonduality is essential to harnessing the health benefits of meditation.

Democrite
Democritus meditating on the seat of the soul by Léon-Alexandre Delhomme (1868).
Ontological conflict in meditation research.

Having experienced the benefits of meditation firsthand, I’m puzzled by the problems that we psychologist have in demonstrating its full curative potential. Scientists have published details of ten thousand meditation and mindfulness experiments over the last eighty years. Yet cognitive psychology is still describing research in this area as ‘preliminary’. As meditation scientists, particularly practitioners who have experience of the benefits of meditation, we should be asking ‘what is limiting progress in this field?’ My current thinking has settled on two questions; how does a spiritual practice become a medicalised practice and what is lost and gained in this transition?

My research follows the trajectory of medicalised meditation, which includes the early progress of electroencephalographic (EEG) studies and the development of the Zen school of psychotherapy. These landmarks represent two interconnected but separate strands of the same story, scientific appropriation and psychological integration. I’ve been puzzled that the critical question of the potential for ontological conflict appears to be absent from the scholarly literature. I’m sure even the most positivist scientists would acknowledge the possibility for theoretical conflict when relocating meditation from the temple to the laboratory. So how is it that the potential for ontological conflict is almost totally absent from the literature? However, my ideas required revision after I bumped into Fritjof Capra’s 1975 paper Modern Physics and Eastern Mysticism.1

Although Capra was known to me, I hadn’t read any of his early research. Now in his eighties, I thought of him as a physicist developing system theories linked to sustainability. What I discovered was his thinking on ontological conflicts between Eastern and Western knowledge systems. This paper illustrates that a theoretical conflict between Buddhist knowledge and science was under discussion during the 1970s. What happened to it, where did it go? I don’t offer Capra’s work as a solution to the crisis in mindfulness, he was writing from the point of view of quantum physics; and from a cognitive perspective, he even muddies the water. However, his paper describes the world views of Buddhism, Hinduism and Taoism, comparing them with Western science.2 He also introduces the subject of nonduality to the science of meditation. In doing so, he highlights more than a dozen problems manifest in the contemporary scientific understanding of Buddhist meditation. One of which I’m going to discuss here; world views as either organic or mechanistic.

Strategic reviews of research published since 2016 generally identify two limitations in the science of meditation, an absence of theoretical frameworks and widespread methodological flaws. The lack of a cohesive ontology (framework) is the greater of the two problems. Without a guiding rationale, the scientific method can become idiosyncratic, entangling the means with the ends. Individual understandings and approaches to experimental psychology lead to several problems, not least issues replicating findings. in meditation research that we still lack construct validity and thus also robust psychometric instruments. Capra’s paper sets out some unresolved issues that might help explain limitations in the scientific study of meditation.

The essence of his argument is that while the mystical East has an organic world view, the West has invested heavily in mechanistic understandings of nature. Capra’s paper is 45 years old; much has changed in physics, psychology and contemplative science in this time.3 But as a theoretical study, Modern Physics and Eastern Mysticism deals with overarching concerns that are almost timeless. Capra argues that the view of ‘reality’ developed in the West rests on certain principles, such as those set out by the anatomist Democritus. The progression of this view led to the creation of classical physics and established dualism as the Western way of understanding almost everything. As the origins of Buddhism and Hinduism predate Democritus, traditional meditation sits on different theoretical foundations.  

The division of nature into separate objects is, of course, useful and necessary to cope with our everyday environment, but it is not a fundamental feature of reality.

1Fritjof Capra, p. 21.

These Eastern understandings see nature as interconnected on the highest level. From this vantage point, Western categorisations and laws of nature appear as constructs, built by mental processes rather than absolute ‘truths’. Capra offers a deal of evidence from quantum physics to demonstrate how this proposition might work. But for the psychological sciences, the value of this insight is self-evident, humans rarely respond to complex phenomena in a universally predictable manner. And where experiments reveal ‘universality’ in human behaviours, several factors influence the data, including society and the experimental method. You don’t need a laboratory to illustrate the limitations of dualistic models of mind and body; it’s sufficient to sit quietly and think about it.

So what does this ‘dated’ consideration of quantum physics mean for our understanding of meditation? This work’s essence highlights fundamental differences between ontologies (theories of being) of East and West. Suggestive of a conceptual gap between meditation’s original function and purposes and positivism’s ability to relate to them. That the West follows a ‘culturally situated’ mechanistic presumption of causality, even when considering human nature.4 Not to claim that Newtonian physics doesn’t ‘work’, but suggesting that it is one approach in a more sophisticated understanding of life. Psychology’s failure to recognise the importance of base ontology when appropriating culturally ‘diverse’ technologies is fascinating. Have we been we trying to understand meditation through the effect rather than the cause? This kind of thinking might explain the lack of replicated results after eight decades of experimentation.5

Despite over-generalisation problems, Capra offers insights into why a traditional understanding of meditation might be almost incomprehensible to positivist science. That a scientist (or even a meditator) rooted in a dualistic viewpoint cannot access the path to a nondual understanding.  Advocates of contemporary secular methods can maintain that the ontologies of mystical traditions are unrelated to modern mindfulness. This notion could be a reliable observation, but it gives rise to two at least two problems. It translates meditation to cognitive behavioural therapy (CBT), perhaps one reason why modern secular meditation methods rarely outperform CBT in clinical trials. But also that the benefits of traditional meditation are universal and profoundly different from those offered by CBT. Using positivism to define meditation risks converting nativist knowledge to known frames of reference, inevitably missing the opportunity to further develop psychology into new and potentially profitable areas. For my research, the discovery of the Capra paper presents a new problem. Why has the potential for ontological conflict between dual and nondual knowledge systems been ignored in the psychological literature?

Notes:

1 Capra, F. (1976). Modern physics and eastern mysticism. Journal of Transpersonal Psychology, 8(1). http://www.atpweb.org/jtparchive/trps-08-76-01-020.pdf

2 Capra also discusses Hinduism and Taoism in this paper. Grouping ideas from different Buddhist schools or diverse religio-philosophical systems can lead to over-generalisations, each of the points made needs to considerer on its individual merit.

3 I’m unfamiliar with Capra’s later studies; his views may have changed radically since this paper was published. I’d be delighted to hear from you if you are familiar with his recent work, feel free to email me or post comments in the text box below.

4 Capra’s thinking embraces physics generally, the emphasis on human behaviour here is my focus rather than a reflection of the paper under discussion.

5 While the existing positivist ontologies present in cognitive psychology offer investigatory potential; there are two problems if traditional meditation is based on a Western world view.  Firstly without cognisance of the spiritual frameworks, the contemporary interpretation of the original practices may lack elements foundational to its understanding. Secondly, while positivist approaches will produce data, what is measured, and how it is understood may be unrelated to the spiritual meditation.

A history of meditation; from the temple to the laboratory

The scientific history of meditation reveals that we may be overlooking many important findings from the past.

The history of meditation and mindfulness
The history of meditation and mindfulness

A history of meditation and mindfulness

In the last century, we have seen four or five (it depends on how you categorise the research) waves of engagement between science and spiritual/meditation technologies. Careful attention to the successes and failures of each of these waves gives us important insights into the current crisis in meditation research. Understanding how the curative potential of meditation has been altered by its relocation to science should accelerate the development of more effective interventions. However, there are few reliable accounts of the scientific history of meditation from which to evaluate our progress. This short introduction highlights some of the important and often disregarded progress from past decades.

Buddhist meditation had been migrating for two and a half thousand years. From its conceptual birthplace in Northern India, Buddhism developed many schools and approaches, all loosely tied to foundational theoretical frameworks.[1] Buddhist meditation methods became transnational spiritual practices, frequently adapted to local conditions whenever they established a foothold.[2]

D. T Suzuki (image from Wikipedia)

The relocation of Buddhism from Asia to the West gained momentum in the first half of the twentieth century, bringing Buddhist knowledge and meditation to many Westerners for the first time. But as well as introducing Zen Buddhism to many in the West, academic and Zen teacher Daisetsu Teitaro Suzuki was also redrawing the boundaries between psychology and religion.[3] Suzuki’s ideas were shaped by the time he spent living and working with Paul Carus at the start of the twentieth century. Carus was an advocate of monism, a concept expressed through the Religion of Science (RoS). [4]  The RoS held that a positivist symmetry existed between elements of science and religion. By the middle decades of the twentieth century, Suzuki had become increasingly influential with Western academics and opinion formers such as Alan Watts and Erich Fromm.

Fromm drew on Suzuki’s reformed, psychologised version of Zen to develop Zen psychotherapy in the late 1950s.[5] Fromm’s interest in Zen was part of a broader movement, and during the 1960s Eastern spiritual traditions became increasingly important in America and Britain. Promoted by poets, philosophers and global celebrities such as The Beatles, meditation in general and Transcendental Meditation, in particular, expressed the aspirations of a generation.[6] The growing Counter Culture became increasingly suspicious of mechanistic approaches to health and wellbeing.[7] Meditation and spiritual world views were seen by many as an antidote to the restlessness caused by an overbearing ‘technocracy’ and processes of dehumanisation.[8]

History of meditation
EEG test (image from Wikipedia)

Alongside the Carus-Zuzuki-Fromm confluence of psychology and traditional spiritual thought, there was a second, more scientific engagement with Eastern meditation traditions. Early accounts of the effects of meditation on the brain can be found in the electroencephalographic (EEG) literature from the 1930s.[9] The following decades were punctuated with several important peer reviewed papers from philosophical, psychoanalytical, physiological and psychological perspectives. A key breakthrough in the scientific understanding of the effects of meditation came with NN Das’s and Henri Gastaut’s research in 1955.[10] By studying brain wave activity alongside other physiological indicators, Das and Gastaut helped to establish the methodology that dominated meditation research for the following two decades.

EEG studies became much more commonplace during the 1960s. Researchers from several countries (France, Germany, India and Japan in particular) confirmed a correlation between the frequency and strength of alpha brain waves and meditative states. But in 1970, a study of Transcendental Meditation (TM) published in Science took the scientific and public interest in meditation to new levels.[11] Keith Wallace’s claims that alongside a range of potential health benefits, TM practitioners could access a novel state of consciousness, inspired meditation researchers for a decade. The 1970s saw a rapid growth in TM studies in experimental and applied settings. In the early 1970s, Wallace joined forces with the cardiologist and health researcher Herbert Benson. Using novel methodological approaches, Benson and Wallace provided further evidence that the practice of TM could lead to improved health and wellbeing.[12]

By 1974 Benson’s research had changed direction, he went on to describe the relaxation response (RR), a ‘grand theory’ that made sweeping claims for a relaxed cognitive state.[13] Benson aggregated operational elements from many different spiritual practices into four essential components that could deliver the relaxation response. Despite a successful book about the RR (written by Benson and Miriam Klipper), the science underpinning the hypothesis never received universal scientific acceptance.[14] By 1980 the scientific community had begun to evaluate‘progress’ made in the study of meditation. Deep-seated methodological and theoretical issues with TM research led to critical reviews from scientists such as Michael West.[15]

However, setbacks to the reputation of meditation research did not thoroughly dampen enthusiasm for the technology. Several new approaches were delivering positive findings, such as Vikram Patel’s combination of biofeedback and meditation to reduce stress.[16] At the start of 1980, there was a growing acceptance of the curative potential of Eastern non-positivist interventions, such as meditation (as well as yoga and acupuncture).[17] But a critical view of meditation research had raised questions about how psychology might best harness the curative potential of meditation.

When viewed from a history of science perspective, many of the strengths and weaknesses in contemporary meditation research are visible in previous ‘waves’. I acknowledge the Western-centric nature of this account. Some potentially important research originating outside of America and Britain, remains to be fully reviewed. But a clear conclusion from this brief summary is that if we don’t pay attention to reliable science from the past, we risk repeating the same mistakes and also missing important findings from earlier work.

(Based on a history of meditation paper prepared for the ERC BodyCapital conference October 2020).

Biblography


[1] Ronkin, Noa, Early Buddhist Metaphysics: The Making of a Philosophical Tradition (London: Routledge, 2005).

[2] Stephen C. Berkwitz, Buddhism in World Cultures (ABC-CLIO, 2006).

[3] Robert Sharf, ‘The Zen of Japanese Nationalism’, History of Religions, 33.1 (1993), 1–43. https://www.journals.uchicago.edu/doi/abs/10.1086/463354

[4] Carl T. Jackson, ‘The Meeting of East and West: The Case of Paul Carus’, Journal of the History of Ideas, 29.1 (1968), 73. https://www.jstor.org/stable/2708466?seq=1

[5] Erich Fromm, Psychoanalysis and Zen Buddhism (New York: Open Road Media, 2013). https://philpapers.org/rec/FROPAZ

[6] Anne Harrington and John D. Dunne, ‘When Mindfulness Is Therapy’, American Psychologist, 70.7 (2015), 621–31. https://dash.harvard.edu/bitstream/handle/1/25757884/97605608.pdf?sequence=1

[7] Saks, Mike, ‘Medicine and the Counter Culture’, in Companion to Medicine in the Twentieth Century, ed. by Roger Cooter and John Pickstone (Abingdon: Routledge, 2003), pp. 113–24

[8] Theodore Roszak, The Making of a Counter Culture: Reflections on the Technocratic Society and Its Youthful Opposition. (Oakland: University of California Press, 1995).

[9] Walter, W. G., ‘Critical Review: The Technique and Application of Electro-Encephalaography’, Journal of Neurology, Neurosurgery & Psychiatry, 1.4 (1938), 359–85. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1088109/pdf/jnpsychiatry00020-0059.pdf

[10] N Das and H Gastaut, ‘Variations in the Electrical Activity of the Brain, Heart, and Skeletal Muscles during Yogic Meditation and Trance’, Electroencephalography and Clinical Neurophysiology, 6 (1955), 211-219.

[11] Robert Keith Wallace, ‘Physiological Effects of Transcendental Meditation’, Science, 167.3926 (1970), 1751–54. https://science.sciencemag.org/content/167/3926/1751.abstract

[12] Robert Keith Wallace, Herbert Benson, and Archie Wilson, ‘A Wakeful Hypometabolic Physiologic State.’, The American Journal of Physiology, 221.3 (1971), 795–99. https://journals.physiology.org/doi/abs/10.1152/ajplegacy.1971.221.3.795?journalCode=ajplegacy

[13] Herbert Benson, John F. Beary, and Mark P. Carol, ‘The Relaxation Response’, Psychiatry, 37.1 (1974), 37–46. https://search.proquest.com/docview/1301437094

[14] Herbert Benson and Miriam Klipper, The Relaxation Response (New York: Collins, 1976).

[15] Michael West, ‘Meditation.’, The British Journal of Psychiatry : The Journal of Mental Science (Cambridge University Press, 1979), 457–67. https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/abs/meditation/BCF552D109C0184ADCF979EBAE736915

[16] C. H. Patel, ‘Yoga and Bio-Feedback in the Management of Hypertension’, The Lancet, 302.7837 (1973), 1053–55. https://www.sciencedirect.com/science/article/abs/pii/S0140673673926603

Misunderstandings of mind

An ever changing relationship between psychology and Buddhism reveals the transient nature of mindfulness meditation in the West.

the relationship between Buddhism and psychology

In the Western history of Buddhist theory and practice, traditional forms of Buddhism have been relatively stable during the twentieth century. New Buddhist traditions and Buddhist inspired movements have emerged in that time, but many of the established schools have demonstrated a surprising continuity. However, since 1900 psychology has undergone radical transformations, leading to changes in both mainstream and peripheral approaches. Therefore the current engagement between Buddhism and psychology, in the form of the science of mindfulness, should be seen as transient and merely the latest stage in the relationship.

Research into the history of the West’s engagement with meditation led me in pursuit of a book written by Caroline Rhys Davids1 in 1914. I haven’t yet tracked down a copy of this work. But several published reviews can be found through resources such as Google Scholar. Without reading Davids’s treatise, I wouldn’t wish to suggest it was representative of any or all of Buddhist psychology; that’s not my point. Instead, the reviews of her work appear, in some quarters, to accept that Eastern understandings of mind might be able to contribute to Western scientific knowledge. In one such appraisal, Walter Clark from the University of Chicago wrote in 1916:

The study of Buddhist psychology is of much interest to us because of the fact that it gives us a carefully worked out analysis of mental phenomena from the point of view of an entirely different “tradition of thought.” Its parallelism to and difference from our own psychological thinking opens up many problems which are of the utmost importance in the study of thought in general.2

pile of assorted title book lot selective focus photographt

Clarke’s review indicates apparent scholarly respect for Eastern sciences of mind. Suggestive of the potential for collaborative rather than appropriative perspectives of Buddhist understandings. There have been several Western scholars that demonstrate an appreciation of traditional (Eastern) forms of psychology, but these are mainly found in the humanities rather than the sciences. A scientist investigating traditional meditation methods rarely links their work to underlying Buddhist concepts, citing relevant texts.

By drawing attention to the evolving nature of psychology, it is a reminder that Western science is in a state of flux in some regards. That what counts as ‘scientifically validated’ psychology today, may well be washed away by a ‘post-cognitive’ movement over the next decades. Conversely, much traditional Buddhist thought and practice has a core of knowledge that extends back hundreds and occasionally thousands of years. In this regard, Buddhist writings on mind, consciousness, and meditation are an underutilised resource in the study and use of meditation technologies.

 

Notes

1 Buddhist Psychology: An Inquiry into the Analysis and Theory of Mind in Pali Literature. By Caroline Augusta Foley Rhys Davids. London: G. Bell & Sons, 1914. 212 pages. 2s. 6d.

2 The emphasis is mine. Clark, Walter E. “Buddhistic Psychology.” (1916): 139-141.

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