problems with meditation

Dependable scientific evidence has lagged worrisomely behind the rapid and widespread adoption of mindfulness and meditation for pursuing an array of mental and physical wellness goals, wrote a group of 15 experts in a new article in Perspectives on Psychological Science, a journal of the Association for Psychological Science. The article offers a “critical evaluation and prescriptive agenda” to help the burgeoning mindfulness industry replace ambiguous hype with rigor in its research and clinical implementations.

Recent years have seen a huge surge not only in media and scientific articles about mindfulness and meditation, the authors wrote, but also in the implementation of medical interventions for everything from depression to addiction, pain and stress. The widespread adoption of therapies has put the field at a critical crossroads, the authors argued, where appropriate checks and balances must be implemented.

“Misinformation and poor methodology associated with past studies of mindfulness may lead public consumers to be harmed, misled and disappointed,” they wrote.

Co-author Willoughby Britton, an assistant professor of psychiatry and behavior at the Warren Alpert Medical School of Brown University said: “We are sometimes overselling the benefits of mindfulness to pretty much any person who has any condition, without much caution, nuance or condition-specific modifications, instructor training criteria, and basic science around mechanism of action. The possibility of unsafe or adverse effects has been largely ignored. This situation is not unique to mindfulness, but because of mindfulness’s widespread use in mental health, schools and apps, it is not ideal from a public health perspective.”

Lead author Nicholas Van Dam, a clinical psychologist and research fellow in psychological sciences at the University of Melbourne in Australia, said that the point of the article is not to disparage mindfulness and meditation practice or research, but to ensure that their applications for enhancing mental and physical health become more reflective of scientific evidence. So far, such applications have largely been unsupported, according to major reviews of available evidence in 2007 and again in 2014.

“The authors think there can be something beneficial about mindfulness and meditation,” Van Dam said. “We think these practices might help people. But the rigor that should go along with developing and applying them just isn’t there yet. Results from the few large-scale studies that have been conducted so far have proven equivocal at best.”

Added co-author David E. Meyer, a professor of psychology at the University of Michigan, “Sometimes, truly promising fields of endeavor get outstripped by efforts to harvest them before they’re really ripe; then workers there must step back, pause to take stock, and get a better plan before moving onward.”

A young, undefined field

Among the biggest problems facing the field is that mindfulness is poorly and inconsistently defined both in popular media and the scientific literature. According to the authors, there “is neither one universally accepted technical definition of ‘mindfulness’ nor any broad agreement about detailed aspects of the underlying concept to which it refers.” As a result, research papers have varied widely in what they actually examine, and often, their focus can be hard to discern.

“Any study that uses the term ‘mindfulness’ must be scrutinized carefully, ascertaining exactly what type of ‘mindfulness’ was involved, what sorts of explicit instruction were actually given to participants for directing practice,” the authors wrote. “When formal meditation was used in a study, one ought to consider whether a specifically defined type of mindfulness or other meditation was the target practice.”

“Without specific, well-defined terms to describe not only practices but also their effects, studies of interventions such as mindfulness-based stress reduction (MBSR) cannot provide valid and comparable measurements to produce reliable evidence.” As part of its proposed remedy, the new article offers a “non-exhaustive list of defining features for characterizing contemplative and medication practices.”

Greater rigor

Along with specific, precise and standardized definitions, similar improvements in research methodology must also come, the authors wrote.

“Many intervention studies lack or have inactive control groups,” Van Dam said.

The field also has struggled to achieve consistency in what it is being measured and how to measure those things perceived to be of greatest importance to mindfulness.

Van Dam said the situation is akin to earlier psychological research on intelligence. This concept proved to be too broad and too vague to measure directly. Ultimately, however, psychologists have made progress by studying the “particular cognitive capacities that, in combination, may make people functionally more or less intelligent,” he and his co-authors wrote.

Thus, the authors wrote, “We recommend that future research on mindfulness aim to produce a body of work for describing and explaining what biological, emotional, cognitive, behavioral and social, as well as other such mental and physical functions, change with mindfulness training.”

Clinical care

A wide variety of contemplative practices have been studied for an even larger variety of purposes, yet in both basic and clinical studies of mindfulness and meditation, researchers have rarely advanced to the stage where they can confidently conclude whether particular effects or specific benefits resulted directly from the practice. Measured by the National Institutes of Health’s stage model for clinical research, only 30 percent of mindfulness-based interventions (MBIs) have moved past the first stage, and only 9 percent have tested efficacy in a research clinic against an active control.

“Given the absence of scientific rigor in much clinical mindfulness research, evidence for use of MBIs in clinical contexts should be considered preliminary.,” the authors wrote.

The proposed agenda for future research is rigorous and extensive, Van Dam said.

“Replication of earlier studies with appropriately randomized designs and proper active control groups will be absolutely critical,” the authors continued. “In conducting this work, we recommend that researchers provide explicit detail of mindfulness measures, primary outcome measures, mindfulness/meditation practices and intervention protocol.”

Researchers and care providers involved with delivering MBIs have begun to become more vigilant about possible adverse effects, the authors wrote, but more needs to be done. As of 2015, fewer than 25 percent of meditation trials actively monitored for negative or challenging experiences.

Contemplating contemplative neuroscience

Van Dam said recent efforts to assess the neural correlates of mindfulness and meditation with technologies, such as magnetic resonance imaging (MRI) and magnetoencephalography, may perhaps have the potential to bring new rigor to the field. Nonetheless, he and his co-authors also express concern in the article that these technologies so far have not fulfilled this potential.

The authors note that technologies such as MRI depend on subjects remaining physically still while being tested, and image quality can be affected by subjects’ rate of breathing. Experienced meditators may be better suited to maintaining ideal physiological states for MRI studies than are inexperienced individuals or non-meditators. Due to such problematic factors, between-group differences in brain scans might have little to do with the mental state researchers are attempting to measure and much to do with head motion and/or breathing differences.

“Contemplative neuroscience has often led to overly simplistic interpretations of nuanced neurocognitive and affective phenomena,” the authors wrote. “As a result of such oversimplifications, meditative benefits may be exaggerated and undue societal urgency to undertake mindfulness practices may be encouraged.”

Ultimately that’s the authors’ shared concern: Insufficient research may mislead people to think that the vague brands of “mindfulness” and “meditation” are broad-based panaceas when in fact refined interventions may only be helpful for particular people in specific circumstances. More, and much better, scientific studies are needed to clarify these matters. Otherwise people may waste time and money, or worse, suffer needless adverse effects.

“This paper is a coordinated effort among concerned mindfulness researchers and meditation scholars to rectify this gap to maximize benefit and minimize harm from MBIs,” Britton said.

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On becoming disconnected from oneself in meditation

September 24, 2015

Bodhipaksa

on practice

I often receive questions by email. Although I’ll sometimes reply directly to them, it strikes me that the best use of my time is to share my responses publicly, so that others might benefit.

Here’s the question, which came from someone who I’ll call Josh.

For a while now, I have been meditating and my body has remained tense – as I am usually quite tense – but my mind relaxes, but in a negative way; it is as if I begin to mentally and emotionally feel numbed out and lost. I would like to be able to meditate on the tension, on emotions, on really anything that’s going on within me, but I end up frustrated and confused because I feel that sense of numbed out and unable to reconnect. I wanted to ask if this is as at all common and if you had any suggestions on how to reconnect and deepen the practice regarding this issue.

Decades ago, when I was first starting to practice meditation, I’d occasionally hear warnings from my teachers about how certain approaches to practice could result in emotional “alienation.” The founder of the tradition in which I practice had come back to the UK from India, and came across (or heard about) a few individuals who had become disconnected from their own experience to the extent that they were “robotic.” One of the things they’d been doing, apparently, was “noting,” which means adding a silent mental note, describing what’s going on in one’s experience.

Noting in this way can be a valuable practice, helping us to be more mindful and clear. But in the case of these people, the mental experience of noting became a replacement for the actual physical experience that was being described. While saying “arm lifting, arm lifting” and “sipping tea, sipping tea,” the thoughts, rather than the actual physical experiences, had become the focus of attention. And having become disconnected from the body, emotional disconnection would follow. Apparently some people became hospitalized as a result of this emotional disconnection, which we now call “depersonalization.”

Despite having heard warnings about the danger of this, I never actually came across anyone who seemed to have suffered in this way. But in recent years (probably because on the internet you can find anything) I’ve heard several people say that this, or something very similar to it, has happened to them. The Brown University psychiatry researcher, Willoughby Britton, has started a project to document and study this and other troubling phenomena that may arise in meditation.

I don’t know if this depersonalization is exactly what’s happened with Josh. Most people who write to me about their meditation practice forget to mention what kind of meditation practice they’re actually doing, but probably he’s doing some form of mindfulness practice. He may not be doing “noting,” however.

But, mindfulness practice isn’t enough. The warnings I’ve referred to were in the context of emphasizing how important lovingkindness (metta), compassion, and other more emotion-based forms of meditation are. The Buddha himself taught a wide range or practices, and encouraged an all-round path of moral and emotional development.

The Triratna tradition in which I practice stresses the importance of balancing mindfulness practice with metta practice. I suggest to my students (as it was suggested to me) that practice consist of alternating metta meditation with mindfulness practice. One suggestion is to do these practices on alternate days, making sure that you don’t skip one of them because you find it more challenging. It may, however, be acceptable to focus on one practice more intensively if it’s genuinely needed. For example when you’re exceptionally distracted, you might focus more on mindfulness for a few days, or if you’re in a chronic bad mood or tend to be very critical you might want to do much more metta practice for a while—perhaps even for weeks or months.

There are other practices that are useful as well. Kalyana mitrata (spiritual friendship) is a valuable way to connect with others on an emotional as well as an intellectual level. Devotional practice can also awaken the heart. Physical exercise and the enjoyment of the arts are also ways that we can stay in touch with our emotions.

One thing to beware of is long periods of intensive practice that involve only mindfulness. Some people do fine with that, but if there’s a tendency to lose touch with the emotions, then it would be best not to be too “gung-ho” about practice, and to be gentle with oneself.

My advice to Josh would be to stop whatever practice he’s currently doing and to take up lovingkindness and compassion practice. I’d suggest focusing exclusively on those for at least six months. If possible he should connect with a sangha (a flesh and bones one rather than an online one) on a regular basis. A sangha that encourages discussion and friendship would be more valuable than one in which people merely sit together but don’t socialize or even communicate much. And the other things I’ve suggested—physical exercise and enjoyment of the arts—are something I’d also strongly encourage. Retreats focusing on lovingkindness and compassion might also be helpful.

Fortunately what Josh describes isn’t common. And I’m fairly sure that the approach I’ve described will be helpful. I’ve taught thousands of people to meditate and so far I’ve never heard of this kind of depersonalization happening to anyone I’ve known.

The dark knight of the soul

June 28, 2014

Read the original article »

Tomas Rocha, The Atlantic: For some, meditation has become more curse than cure. Willoughby Britton wants to know why.

Set back on quiet College Hill in Providence, Rhode Island, sits a dignified, four story, 19th-century house that belongs to Dr. Willoughby Britton. Inside, it is warm, spacious, and organized. The shelves are stocked with organic foods. A solid wood dining room table seats up to 12. Plants are ubiquitous. Comfortable pillows are never far from reach. The basement—with its own bed, living space, and private bathroom—often hosts a rotating cast of yogis and meditation teachers. Britton’s own living space and office are on the …

Meditation study links history to science

February 3, 2014

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Ashna Mukhi, Brown Daily Herald: Meditation study links history to science; Light experiences during meditation similar to visualizations caused by sensory deprivation.

Practitioners of Buddhist meditation have reported seeing globes, jewels and little stars during meditation-induced light experiences. The neurobiological explanation for these visions was the subject of a recent study led by Willoughby Britton, assistant professor of psychiatry and human behavior, and Jared Lindahl, professor of religious studies at Warren Wilson College in North Carolina.

The study, published in the journal Frontiers in Psychology Jan. 3, connects first-hand accounts of these light experiences and reports of them from Buddhist texts to scientific literature …

The dark side of meditation

August 14, 2013

Bodhipaksa

on practice

Here’s an interesting conversation between Brown University neuroscientist (and meditation teacher) Willoughby Britton and yoga and Buddhism teacher Michael Stone. Britton, as a good scientist, is interested in cataloguing the confusing, unpleasant, and sometimes harmful effects that meditators may experience, including cognitive and sensory aberrations, emotional difficulties or challenges, changes sense of self, and disturbing physiological manifestations.

My experience is that adverse effects to meditation are rare. Some manifestations in fact may not be at all harmful and may be signs of progress in meditation (e.g. changes in the perceived relative size of different parts of the body) but might be mistaken for “going crazy.” Other manifestations — such as some people who have contacted me to discuss a complete loss of emotional affect — are clearly very destructive and need to be investigated.

Britton makes the point that some approaches to meditation have ripped mindfulness from its traditional context, where it’s embedded in a framework of practice that includes intellectual understanding, ethical observance, devotion, and practices such as the brahmaviharas, and present it as a stand-alone practice. This may work for many people, but it may also lead to problems.

The fact that meditation is not enough something I’ve written about. I’ve also written about how some people, though an unbalanced approach to practice, can become disconnected from themselves.

Relaxing is stressful for some

November 19, 2012