mindfulness – The Science of Meditation and Mindfulness

Meditation and negative side effects: the latest research

A 2020 review of mindfulness research highlights a reluctance to acknowledge potential adverse effects.

contrasting emotions — The effects of meditation based brain training are neither uniform nor universal

Scientists and clinicians, generally speaking, attempt to make the world a better place. Many of us working with mindfulness have confidence that this human technology has significant curative potential. But a health and wellbeing intervention cannot be built on my confidence or compassionate aspiration. It requires objective results produced through reliable scientific methods. Such results should offer a comprehensive understanding, including indications of problematic side effects. This summer, perhaps for the first time, a journal article has summarised adverse events linked to meditation practice (MAE).¹

In a recent review of Richard Layard’s manifesto for happiness, I highlighted the tension between wanting mindfulness to be an effective panacea and making the scientific case for its widespread use. This dilemma is well known to psychologists. We direct our research towards a desired outcome, a plausible hypothesis, reliant on the scientific method to ensure our work remains objective and unbiased. Methodologically robust results of experiments and clinical trials should deliver a balanced and replicable set of data. If the data is not objective or if a later investigation cannot repeat the results, the scientific reliability may be open to question. Within the psychological sciences, these conflicting forces have long been a major source of concern.

Psychology has been locked into a so called replication crisis for several decades.² Meditation research shares characteristics of this malaise, but scientists working in this field have highlighted several additional concerns. Meditation based mind training ultimately mediates brain function and structure; none of our higher (cortical) brain functions work in isolation. When activity in one area attenuates, we may see a correlated augmentation in an anatomically separate region. Put simply: brain training can simultaneously have different effects, these effects can vary from person to person. This truism of neuroscience should ensure that when meditation based health interventions are studied, both beneficial and adverse potentials are considered.

In August of this year, a research team (Farias, Maraldi, Wallenkampf and Lucchetti) published a strategic review of meditation studies in Acta Psychiatrica Scandinavica. ‘Adverse events in meditation practices’ investigated almost half a century of meditation research, a total of 6,742 citations. Of those papers, only 83 met the project’s inclusion criteria. Across this sample, the study found MAEs in 8.3% of cases. That meditation practice has been scientifically correlated with problems in some practitioners is a significant finding in its own right. But a second issue, the tendency of meditation and mindfulness research to focus on positive outcomes to the exclusion of other considerations also needs to be taken very seriously. When the science of meditation is explored from a historical perspective, this lack of objectivity has been a recurrent problem for a long time, at least fourty years. Its root causes go back to early engagements between non-positivist knowledge systems and psychology.

The Farias et al. paper signposts a potential new trajectory for the science of meditation. It doesn’t, however, offer any explanation of why adverse side effects receive a low research priority. Given the codes of ethics and conduct underpinning experimental and clinical psychology, future research will need to take the question of MAEs more seriously. However, two overarching consideration require urgent attention. Firstly, on the theoretical and operational level what happened to spiritual meditation when it relocated to psychology? And why, despite thousands of experiments over at least eighty years, is our scientific knowledge of meditation still described as ‘preliminary’?

Notes

¹Farias, M., Maraldi, E., Wallenkampf, K. C., & Lucchetti, G. (2020). Adverse events in meditation practices and meditation‐based therapies: a systematic review. Acta Psychiatrica Scandinavica.

² Maxwell, S. E., Lau, M. Y., & Howard, G. S. (2015). Is psychology suffering from a replication crisis? What does “failure to replicate” really mean?. American Psychologist, 70(6), 487.

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?

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.

Meditation can change the size of your brain

The brain is plastic, to what extend does it undergo structural changes during meditation?

Authors: Kieran C.R. Fox, Savannah Nijeboer, Matthew L. Dixon, James L. Floman,
Melissa Ellamil, Samuel P. Rumak, Peter Sedlmeier, Kalina Christoff

Year: 2014

Title: Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners

Summary: Like almost every contemplative scientist will point out, our understanding of what meditation can do for us in its infancy. However, this investigation sets out the progress made in understanding meditation related to structural changes in the brain. The researcher identified 21 studies that imaged the brains of meditators, looking for structural changes. Although most of the research was cross-sectional in nature some ‘before and after’ examples are included.

This project reviewed research that used any of the six leading measures of structural changes in the brain (volumetry, concentration, thickness, fractional anisotropy (FA), diffusivity (axial and radial) and gyrification). The selected papers were qualitatively reviewed and also subject to an anatomical likelihood estimation (ALE) meta-analysis. Qualitative results highlighted nine brain areas that might have undergone structural alteration as a result of meditation practice. Seven areas of grey matter: anterior/mid-cingulate cortex, fusiform gyrus, hippocampus, inferior temporal gyrus, insular cortex, rostrolateral prefrontal cortex, somatomotor cortices and two white matter pathways: corpus callosum, superior longitudinal fasciculus.

Although Lazer et al. made efforts to link the results of morphometric neuroimaging to a range of functional studies there are a number of problems in this approach. There is little structure in how meditators and meditation methods are grouped together, both in creating the meta-analysis and explanations for alterations in brain structures. This in part reflects the limitations of the 21 neuroimaging studies used, it is also linked to the widely documented problems in the theoretical frameworks used by contemplative science. For example, common features are looked for in diverse experiments using different forms of meditation, both secular and spiritual. Although the participants from the experimental groups cited in the studies had all meditated, they often differ significantly in the methods they use, frequency and duration of practice and time spent in intensive meditation retreat.

Despite the limitations, which are in large part symptomatic of meditation research in general, this remains an influential study fo0r both cognitive psychology and neuroscience.

Link: https://www.sciencedirect.com

How much does science know about meditation?

Scientific understanding of meditation and mindfulness

Blogging about a related issue at Meditation for Health prompted me to think about how much does science really know about meditation and mindfulness. Leading scientists in the field state that empirical meditation research is at a relatively early stage. But relative to what? Surely not the efforts of the scientific community, thousands of scientific studies have already been published that explored meditation and/or its presumed operationalised components. It should also be considered that there is a vast body of traditional texts available, documenting many aspects of contemplative sciences over the last two thousand years. Contemporary research should also have benefited from the millions of current practitioners, including meditation masters with great experience of practice and underlying theoretical frameworks. It is hard to imagine more auspicious conditions for the study of meditation, so why is the research struggling to make significant progress?

After I had been meditating for five years I asked a traditional meditation teacher what the goal of my particular practice was. She stripped away the esoteric imagery in which the practice was framed and explained the likely result of my efforts. In particular, she emphasized the importance of my motivation. The idea that the method alone is not the practice is central to many forms of meditation and contemplation. In fact, traditional literature from Tibetan Buddhism makes it clear that progress in a particular method may require the application of significant levels of compassion or non-attachment. It is not my suggestion that a western scientific approach cannot fully understand the processes engaged in different forms of meditation. But rather it might be time to start to think about the phenomena underpinning meditation in a more complete way, even within cognitive psychology or neuropsychology. In some traditional schools, meditators are discouraged from evaluating the progress of others. But when you meditate cheek by jowl in a community of meditators for years, you may inevitably observe differences in the effects of the same meditation practice on different people.

Whilst the capacity of practitioners (individual differences) is a known factor in the experience of meditation. An individual’s motivation is also central to the benefits of a practice. This is a paradigm for all meditators and mindful practitioners in all settings. Unless a scientist can integrate the enthusiasm, scepticism and goals of the meditator into the input part of the equation, great uncertainty regarding the output is inevitable. In a survey of meditators and mindfulness practitioners (Morris, 2017) that included both types of practice and reasons for commencement. The motivation of practitioners was very varied. Among the cited reasons for beginning meditation or mindfulness were:

Motive	%
To improve my health	12
To improve my general well-being	43
For spiritual/religious reasons	22
As a lifestyle choice	6
Because of the influence of others	3
Any other reasons	14

There are reasons to suppose that the motivation of a meditator is a significant influencer on the results of a practice. The empirical approach has a great deal to offer the investigation of meditation, it can help to construct reductionist models able to identify the elements contemplative practice. But we are perhaps at a point when a fuller understanding of meditation and meditators needs to evolve.

References

Morris, S. (2017), An exploration of the relationship between wellbeing and meditation experience amongst meditators and mindfulness practitioners. The Open University, Milton Keynes. Unpublished

Putting the Meditator at the Centre of the Research

Meditators know the most about meditation, if science ignores them they miss a trick.

(The research is now complete, thanks to all who participated)

Do you meditate or practice mindfulness?

I am currently undertaking an academic survey into meditation and wellbeing. I would like to ask meditators over the age of 18 to complete a short anonymous questionnaire about their practice (it should take around ten minutes). The research has been ethically approved and conforms to all the usual academic norms.

This important research seeks to capture the meditation and mindfulness experience of practitioners of different levels of experience and backgrounds. Based on meditators self reported insights, this projects follows recent signposts in contemplative science putting greater emphasis on the experiential nature of mindfulness and meditation.

Regards

SGM

Is Mindfulness Buddhist and Does its Social Context Matter?

Can mindfulness be regarded as a Buddhist practice?

Title: Is mindfulness Buddhist? (and why it matters)

Author: Robert H. Sharf

Year: 2015

Summary: Modern mindfulness meditation is often associated with the state of ‘bare attention’, paying attention in the moment, non judgementally but deliberately. This particular state is not without established precedent in different schools of Buddhism and Robert H. Sharf outlines examples from Burmese reformed Buddhism, the Chinese Chan and Tibetan Dzogchen traditions. This paper also highlights issues associated with the theoretical framework for mindfulness in Buddhism and the relationship between the transformative potential of meditation and the wider context within which meditation is undertaken.

Perspective: Religious studies, psychiatry, health psychology

Link: http://buddhiststudies.berkeley.edu/people/faculty/sharf/documents/Sharf%20Is%20Mindfulness%20Buddhist.pdf

No Agreement over the Meaning of the Term Mindfulness

What is the authentic meaning of mindfulness?

Title: What does mindfulness really mean? A canonical perspective

Author: Bhikkhu Bodhi

Year: 2011

Summary: The mindfulness movement is inextricably linked with Buddhism, both Buddhist teachings and meditation practice. It is then of particular interest when Buddhist scholars of the Pali Cannon, such as Bhikkhu Bodhi question one of the most widely used definitions of mindfulness; ‘bare attention’. This is not simply a philological debate regarding the development and use of the term mindfulness but also a discussion of the fundamental understanding of the human behaviour of meditation. There is also the question of the appropriation and ‘translation’ of the term mindfulness into secular contexts and the implications for both Buddhism and the secular meditation schools.

Perspective: Religious studies

Link: http://www.tandfonline.com/doi/full/10.1080/14639947.2011.564813?src=recsys

The origins of MBSR; Zen and mindfulness

Mindfulness based stress reduction (MBSR) its origins and context.

Title: Some reflections on the origins of MBSR, skillful means, and the trouble with maps

Author: Jon Kabat-Zinn

Year: 2011

Summary: In this frank an open exposition of Jon Kabat-Zinn’s development of the Mindfulness Based Stress Reduction (MBSR) system, readers are given an insight into the background and conditions under which the MBSR concept was transposed. I use the term ‘transposed’ because that appears to be the essence of how Kabat-Zinn positions his work in the context of his experience and knowledge of Zen Buddhism. In this paper he stresses that MBSR and other systems in the mindfulness family should be integrated and consistent with the Buddhadharma (authentic teachings of Buddhism) but not constrained by the historical, cultural and religious phenomenon that exist in the societies where the Buddhadharma has been preserved and may still flourish.

Kabat-Zinn reveals his own close connection with the Zen one thousand year view and this insight perhaps gives a clue to the current academic debate whether the understanding of mindfulness as expressed in MBSR actually reflects mindfulness in Buddhism more generally. Mindfulness in its broader meaning is given a prominent role in this paper and Kabat-Zinn shares his compassionate vision regarding the benefits of the continued growth in the ‘mindfulness’ movement.

Perspective: Health psychology, religious studies,

Link: http://www.tandfonline.com/doi/abs/10.1080/14639947.2011.564844

Mindfulness Meta-study Reveals Conflicting Findings

This meta study finds t conflicts between methodology and findings of mindfulness research.

Title: Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis

Authors: M Goyal, S Singh, EM Sibinga, NF Gould, A Rowland-Seymour, R Sharma, Z Berger, D Sleicher, DD Maron, HM Shihab, PD Ranasinghe, S Linn, S Saha, EB Bass, JA Haythornthwaite

Year: 2014

Summary: In this meta-analysis the effectiveness of meditation programs to impact on stress related outcomes was investigated. Randomized clinical trials where meditation was used by adult clinical populations to reduce the effect of conditions including; anxiety, perceived quality of life, depression, substance use, stress and distress were studied. The analysis included 47 trials with 3515 participants and indicated that mindfulness meditation training delivered moderate evidence of lower anxiety levels, depression and experience of pain and low evidence of improvements to stress, and distress levels. The research found little evidence that meditation had any significant impact on: eating habits, sleep, attention, substance use or positive mood. In conclusion the study found that meditation offered no greater benefit than other active treatments such as drugs, exercise or therapeutic intervention.

Perspective: Health psychology, medicine

Link: http://www.ncbi.nlm.nih.gov/pubmed/24395196

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How far can we trust meditation research?

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