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Can Mindfulness Reduce Anxiety? Reviewing Current Research

From a neuropsychological perspective, there are plenty of reasons to presume that mindfulness should be able to reduce the effects of anxiety in participants. We know that regulating breathing and calm introspection almost always lowers heart rate, blood pressure, skin conductivity and other biological signs of stress and anxiety. Mindfulness practice has been shown to reduce activity in the amygdala, the brain’s fear and threat detection centre, thought to correlate with dampening hyper-reactivity to perceived stressors. There is also evidence that regular mindfulness practice boosts activity in the dorsolateral prefrontal cortex, improving executive control and emotion regulation. However, research in this field has been hampered by poor experimental studies and a lack of robust replication.

Can meditation and mindfulness treat anxiety
How much progress has been made in understanding if mindfulness can solve the anxiety crisis?

A recent randomised controlled trial titled “The Effects of Mindfulness Meditation on Nursing Students’ Stress and Anxiety Levels” by Rhoda Owens and Dawn Denny of the University of North Dakota College of Nursing and Professional Disciplines promised to deliver some much-needed rigour to our data about the effectiveness of mindfulness.

The study was a pretest/posttest randomised controlled trial (RCT) with 145 nursing students as participants. The basic experiment aimed to measure the effectiveness of weekly virtual mindfulness meditation recordings compared to control recordings on nursing information. Data was collected in the experiment through self-reported Perceived Stress Scale (PSS) and Generalized Anxiety Disorder-7 (GAD-7). The results were analysed with a two-way mixed ANOVA. The researchers concluded that ‘mindfulness meditation can reduce stress and anxiety levels in nursing students.’ and that ‘This can improve students’ overall mental and physical well-being.’ Despite the upbeat claim, there were several missed opportunities to create robust findings in this experiment.

In common with almost all previous mindfulness papers, the study lacks adequate detail on participant adherence to meditation recordings. Were sessions tracked or self-reported? Simply put, if we do not know whether participants followed the virtual mindfulness training, can we trust the data? Control conditions are a significant challenge in mindfulness experiments, and this study illustrates why. By using recordings of nursing information, students in the control group would have engaged different cognitive processes than the mindfulness experimental group. For students who are poorly performing or anxious, the nursing recordings could have been stressful or triggering. In this experiment, an active placebo, such as an alternative form of relaxation, may have provided a more effective control (however, the literature generally illustrates that when other forms of relaxation are used as experimental controls in mindfulness studies, little effect is visible).

The total number of participants suggests about 73 people in each condition, which means the experiment was underpowered, given the confident claims made. No blinding procedures were used; participants likely knew their group assignment. Typically for a mindfulness study, it appears to be a short-term effect under investigation, with no follow-up data. The narrow participant pool is also likely to limit the generalisability of the study. In terms of the theoretical framework, no attempt is made to identify causality or describe how specific elements of mindfulness training impact different parts of the brain to reduce anxiety.

This paper offers methodological improvements compared to many earlier anxiety studies, but it falls well short of robust evidence. The critical analysis provided in this blog article must be seen in the context of the progress of meditation research and practice over the last 50 years.

Can mindfulness reduce anxiety
Have scientists been watching the right things?

There are over 35,000 mindfulness and meditation studies published in the peer-reviewed literature at an estimated cost of £5 bn. The total spent on delivering mindfulness training globally is incalculable, but is likely to have cost billions more. Since the 1970s, mindfulness research has been criticised for its failure to deliver clear evidence of its benefits. The most frequent issues reported in research reviews include a lack of appropriate controls and blinding measures, over-reliance on self-reported data, no confirmation of participant engagement and overconfidence in preliminary unreplicated data.

Taking the long view of meditation and mindfulness research, very little clinical or scientific progress has been made over the last forty years. The same errors are being repeated, despite attempts to improve scientific approaches. The question that the psychological sciences need to be asking is why, despite billions of pounds of investment, we cannot provide robust, replicated evidence to support the claims made for mindfulness.

If you have any thoughts about the role of mindfulness in reducing anxiety, or mindfulness research in general, post your comments below or send us an email.

Can Medicalised Mindfulness Evolve?

Could Mindtraining for Life be the long-awaited new dawn for contemplative science?

Most meditation scientists agree that significant progress is needed if contemplative practices are to meet the claims made for their benefits over the last 70 years. Medicalised mindfulness has established a role as a practice that can reduce stress, anxiety, and, in some instances, cognitive dysfunctions. While its clinical applications, especially in protocols like Mindfulness-Based Cognitive Therapy (MBCT), have gained some traction, a growing body of critique highlights its limitations: conceptual vagueness, inconsistent outcomes, and detachment from its philosophical roots.

Robust correlations between regular spiritual meditation practice and improved happiness and wellbeing continue to be observed in peer-reviewed literature and society more generally. Psychology has been attempting to harness the curative power of spiritual meditation for over 70 years.1 It seems that whenever meditation and mindfulness are converted to mechanistic practices, and subject to empirical evaluation, most of the health and wellbeing benefits simply dissolve. In experiments, we frequently see modest changes used as ‘evidence’ that medicalised meditation and mindfulness work (an estimated 97% of mindfulness experiments lack adequate controls).

What will medicalised mindfulness evovle into
Religion and science remain ontologically incompatible

It’s probably not possible or desirable to prescribe religious practices as health interventions; that’s not how the spiritual path works. However, there is evidence that secular forms of meditation could still play a significant role in tackling the mental health crisis unfolding across many advanced economies. Medicalised meditation has consistently failed to establish the active cognitive components present in traditional meditation training. In my own private practice, Mindtraining for Life (MfL), we use rationales consistent with nondual Buddhism and psychology, and the benefits to clients’ happiness, wellbeing and success are clear.

Of course, MfL is one of several emerging frameworks that appear to offer a more structured, cognitively rigorous alternative to medicalised meditation. Its unique element is its integration of profound nondual knowledge outside of an explicitly Buddhist context.

If the mindfulness project has failed, what will replace it?
Science has failed to understand the relationship between meditation and consciousness.

At its core, MfL reframes mental resilience not as a passive state of “non-reactivity,” but as an active, trainable skillset grounded in attentional control, cognitive flexibility, and strategic self-regulation. Unlike medicalised mindfulness, which often relies on Westernised dualistic meditation, materialistic concepts of self and other, and ambiguous notions of “present moment awareness,” MfL emphasises goal-directed mental rehearsal, cognitive reframing, emotional regulation, and a basic training in nondual compassion. These techniques are not only more objectively measurable than current medicalised equivalents but also more compatible with neuropsychological models of executive function and emotional regulation.

From a scientific standpoint, this shift matters. Medicalised mindfulness has struggled with reproducibility, standardisation, effect size variability across populations and the concept of nonduality. Meta-analyses reveal modest benefits despite the creation of hundreds of mindfulness variants. Moreover, reliance on fragmented understandings of introspective phenomenology makes mindfulness impossible to standardise across clinical trials and other experiments. MfL’s protocols can be broken down into discrete cognitive tasks, such as attentional switching, scenario visualisation, nondual progression, and resilience scripting; these are likely more amenable to both behavioural and neuroimaging studies. By focusing on individual client needs as a starting point, MfL has retained the holistic and curative value of traditional nondual practices, complemented by reliable neuropsychology. From this platform, a degree of standardisation and operationalisation is likely. Another way to think about this, is in terms of a bottom-up model for contemplative science. After more than a decade of research in this field, I’m certain medicalised meditation needs a more reliable theoretical framework. By creating successful secular equivalents of nondual practices on a one-to-one basis, then scaling them up, we may be seeing the science of meditation turned on its head.

Another advantage of MfL lies in its philosophical neutrality. Medicalised mindfulness often inherits Western interpretation of Buddhist metaphysics (e.g., non-self, impermanence) without critical examination. It then seeks to place these concepts within psychology’s dualistic framework, leading to ontological confusion. Mindtraining sidesteps this by focusing on cognitive processes rather than spiritual insight. This makes it more accessible to diverse populations and more adaptable to transdisciplinary and interdisciplinary research.

Time to try a new approach to contemplative science

Importantly, mindtraining also addresses a key critique of mindfulness: its tendency to individualise systemic stress. By equipping individuals with tools to observe first and then strategically engage with psychological suffering, thus mind training fosters agency and contextual awareness. This aligns with contemporary models of psychological resilience, which emphasise dynamic interaction between person and environment.

In summary, while mindfulness meditation has opened the door to contemplative science, its medicalised form may have reached a conceptual plateau. Mindtraining, as exemplified by the WfL model, offers a promising evolution, one that is cognitively precise, empirically tractable, and philosophically grounded. For scientists and clinicians seeking robust and scalable interventions to work with, it may be time to shift their focus from passive awareness to active mental agility.

1 Morris, Stephen Gene (2024) The Scientific History of Mindfulness: 1938 to 2020. University of Kent,. (doi:10.22024/UniKent/01.02.106240) (KAR id:106240). https://kar.kent.ac.uk/106240/

Dr Stephen Gene Morris is a Consultant in Applied Neuropsychology and the founder of Mind Training for Life.

Can Mindfulness Meditation Boost Immunity

There are many preliminary scientific studies that indicate meditation improves self-reported measures of disease symptomatology. But what do we know about the link between mindfulness and inflammation?

Does Mindfulness Meditation Boost Immunity
Mindfulness and immunity. (Photo by Anna Shvets on Pexels.com)

Authors: Black, D.S. and Slavich, G.M

Year: 2016

Title: Mindfulness meditation and the immune system: a systematic review of randomized controlled trials.1

Summary: The role of inflammation in health and wellbeing is becoming increasingly important in our understanding of illness and perhaps more important to establish greater resilience to ill health. For example, we now know that an unhealthy gut can lead to inflammation in many different organs. It’s not that inflammation should be seen as the problem per se; it is a function of the immune system, our body’s essential response to harmful stimuli. However, too much or too little inflammation can lead to major and minor health problems. Therefore if meditation can regulate excessive inflammation and its causes before they can damage the body, it will improve health and wellbeing.

Mindfulness meditation and immune system biomarkers. This systematic review of 20 randomized controlled trials, comprising more than 1600 participants, revealed replicated, yet tentative, evidence that mindfulness mediation is associated with changes in select immune system processes involved in inflammation, immunity, and biological aging.1

This scientific review was a meta-study; the authors looked across several different published papers to establish the overall state of research in this field. When analyzed together, these individual papers indicated that: ‘mindfulness meditation modulates some select immune parameters in a manner that suggests a more salutogenic immune profile.’ Simply that practising mindfulness can reduce pro-inflammatory reactions and an increase in the biological mechanisms linked to cell ageing. The study’s authors stress that despite the scope of the paper, the reviewed literature contained some methodological limitations, so the findings of individual studies and the meta-review should be treated with caution. 

What does this study mean for meditation and mindfulness practitioners?

Since the development of medicalised meditation (the relocation of belief based practices into medico-scientific domains) in 1970, the science of meditation has had an increasing tendency to pragmatism rather than empiricism. This means that the effects of meditation and not underlying causal mechanisms tend to be the object of most research projects. This paper represents a movement towards a more rigorous positivist approach, but no definite conclusions were established. My personal view is that the evidence supports much of what we already know about regular meditation practices; it can improve overall health and wellbeing. This paper was published in 2016 but it remains one of the few reviews of the relationship between mindfulness and the immune system.    

Notes:

  1. Black, D.S. and Slavich, G.M., 2016. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Annals of the New York Academy of Sciences, 1373(1).

Link: www.ncbi.nlm.nih.gov

Non-judgement and mindfulness meditation; costs and opportunities

The absence of judgement from medicalised mindfulness suggests an uncoupling from traditional meditation methods. Why did this happen, and what does it mean?

Why was judgement removed from medicalised meditations

Although definitions across contemporary forms of mindfulness are varied, we usually find mindfulness-based interventions (MBIs) are explicitly non-judgemental. In the context of meditation technologies, we think about ‘non-judgement’ being both operationalised in the meditation practice itself and in the broader ethical context surrounding meditation. This lack of judgement in MBIs appears to have been one of its foundational principles, present since its medicalisation1. This absence is somewhat surprising, given the presumed conceptual relationship with Buddhist forms of mindfulness, where judgement and ethics are woven into their theoretical frameworks.

Scholars and practitioners have considered if the non-judgemental approach in MBIs has uncoupled them from traditional forms of meditation, if so what have we lost or gained in the process?2 This debate has been illuminated recently by Chokyi Nyima Rinpoche, who wrote that meditation alone is not enough3. That understanding the ontology and epistemology of the method is an essential part of the meditation process. Although Rinpoche talked specifically about Buddhist practices, his view supports the notion that meditation, stripped of its ethical and judgmental elements, becomes different. We should be clear that although there are Buddhist methods which operationalise a non-judgemental view, they are conducted within an ethical/judgemental setting. However, the questions from a history of science perspective are more linked to how and why things developed this way. What does the apparent paradox (judgemental practices translated as non-judgemental), mean about the scientific context in which mindfulness was established and now resides?

“If we use these precious resources to examine things critically, we can understand both the way things appear and the way they truly are.”

Chokyi Nyima Rinpoche3

From a psychological perspective, the separation of meditation from its foundational judgement and ethics raises three crucial questions. Firstly, given the widespread presence of spiritual practitioners in the research and teaching of meditation, are students of MBIs getting ad hoc judgement/ethics to fill the gap? Secondly, judgement and reflection require engagement with essential processes in the brain’s intrinsic networks; therefore, what are the differences between the results obtained from judgemental and non-judgemental approaches. And finally, if judgement is central to traditional meditation technologies, why has it been removed? It is this last question that holds the greatest significance.

Psychology is free to develop whatever forms of meditation it sees fit; it can also investigate spiritual meditation methods. But the creation of contemporary mindfulness interventions, based on traditional forms prompts questions. If we knew the Buddhist practice(s) mindfulness was translated from, their theoretical and operational components could be established. Then by conducting comparative studies with MBIs, an understanding of what was added or subtracted might be reached. However, the scientific provenance of MBIs is shrouded in mystery; this gap in our knowledge is a probable factor in the failure to establish reliable theoretical frameworks for MBIs.4 Therefore, although contemporary mindfulness stresses a close relationship with Buddhist meditation technologies, this is not generally supported with evidence. So why and how did things turn out this way? Understanding this issue may provide the insights needed to signpost the next stage in mindfulness’s development.

References

1 Kabat-Zinn, Jon. “Some reflections on the origins of MBSR, skilful means, and the trouble with maps.” Contemporary Buddhism 12, no. 01 (2011): 281-306.

2 King, R. (2016). ‘Paying Attention’ in a Digital Economy: Reflections on the Role of Analysis and Judgement Within Contemporary Discourses of Mindfulness and Comparisons with Classical Buddhist Accounts of Sati. In Handbook of Mindfulness (pp. 27-45). Springer, Cham. From a practitioners persective see Bodhi, Bhikkhu. “What does mindfulness really mean? A canonical perspective.” Contemporary Buddhism 12, no. 01 (2011): 19-39.

3 Nyima Chokyi. “Why Meditation isn’t Enough.” Lion’s Roar (2019). https://www.lionsroar.com/why-meditation-isnt-enough/

4 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.

Three limitations in our understanding of meditation and how to fix them

Scientists are challenging claims being made for the benefits of mindfulness. A project to fill in the gaps in our scientific knowledge is an urgent priority.

Limitations in the understanding of meditation and mindfulness
Lack of understanding is limiting the study of meditation

Scientists studying the benefits of mindfulness meditation are still coming to terms with  a systematic review entitled ‘Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation.‘1 The criticisms made in that study pose questions for the use of meditation in contemporary secular settings. This crisis of confidence is not linked to a lack of clinical potential; there are preliminary indications of meditation’s curative effects. The problems rest in the widespread absence of replicated evidence for many of the claims made for meditation technologies. The overview now emerging from the scientific study of meditation is the lack of a ‘big picture’. Psychological science has studied the impact of meditation extensively over the last seventy years, but further progress appears limited by three intractable problems.

The long term sustainability of clinical meditation is threatened by an inability to reflect its successes and failures in equal measure. While it is not uncommon to find pilot studies with small numbers of participants hyped in the media, established theoretical and methodological problems receive modest scholarly or scientific interest. This is not a minor nor recent problem; issues of scientific reliability have stalked meditation research since the middle decades of the twentieth century.

man sitting on rock in front of water fountain

Reviews of published meditation research frequently cite flaws in the methodologies used. For example, many studies find an effect; that when people meditate some measurable change takes place. However, this effect is often established in isolation without any control group. Or on many occasions, the control is a ‘waiting list’ of participants who receive no appropriate intervention or placebo, meaning all the experiment can show is that in one instance the meditation appeared to have a more substantial effect than nothing. As any neuroscientist or neuropsychologist can tell you, a repeated novel activity of almost any kind can lead to an effect, and if continued for long enough new brain function and structure will be observed.

But the failure to establish strong scientific evidence cannot be only put down to an absence of scientific introspection and methodological flaws. The lack of a coherent theoretical framework presents the biggest obstacle to meditation research. Put simply, despite thousands of published papers over recent decades; we still can’t quite settle on definitions of what secular meditations are and how they should work. Many meditation studies reference religious traditions alongside scientific papers with little explanation of how positivism and spirituality can share a common world view. Peer-reviewed studies which contain limitations continue to be cited in recent work, their influence extending well beyond experimental environments.

Scientists working in this field are likely to be familiar with these three areas of concern (lack of reflexivity, methodological and theoretical weaknesses). But elevating the standard of published research remains a challenge. The Van Dam et al. study makes several recommendations, which if adopted, could improve matters, but the critical challenges haven’t been addressed; we lack authoritative accounts of what meditation and mindfulness are. This overarching question is directly linked to the gaps in our knowledge of how meditation relocated to science, what processes were lost and gained. A more rigorous epistemological and ontological understanding of the science of meditation may be our best hope to deliver the stable conceptual foundations urgently needed in the contemplative sciences.

Notes

1 Van Dam, N. T., Van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C. D., Olendzki, A., … & Fox, K. C. (2018). Mind the hype: A critical evaluation and prescriptive agenda for research on mindfulness and meditation. Perspectives on psychological science, 13(1), 36-61.