Does meditation carry a risk of harmful side effects?
"Meditation can leave you feeling even more stressed," the Daily Mail reports.
The claim is prompted by a study of 60 practitioners of Buddhist meditation in the US which found they'd had a range of "challenging or difficult" experiences associated with the practice.
However, it's not clear how relevant the results are to the majority of people who use meditation apps or take mindfulness classes.
The study only included people in Western countries who meditated within one of three Buddhist traditions, and – importantly – who'd had negative experiences. So the numbers of people in the study reporting, for example, fear, is only representative of people who'd said they had a negative experience through meditation, not of all people meditating.
The study does make an important point, however, at a time when mindfulness and meditation has become more popular, that the effects of meditation are not always positive or harmless. Some people in the study reported feeling depressed or suicidal, and a few needed treatment in hospital as a result.
Classical Buddhist literature discusses potential pitfalls of mindfulness and meditation, such as makyō (hallucinations) and "Zen sickness" – a sense of imbalance and loss of identity. So these warnings should not be glossed over by teachers of Buddhist inspired techniques.
Also, healthcare practitioners who recommend meditation need to be aware of the associated risks.
Where did the story come from?
The study was carried out by researchers from Brown University and the University of California in the US. It was funded by the National Center for Complementary and Integrative Health, the Bial Foundation, the Mind and Life Institute and the 1440 Foundation.
The study was published in the peer-reviewed journal PLOS One on an open-access basis, so it is free to read online.
The Mail covered the study particularly badly. It began by sneering at the celebrities and "yummy mummies" that practice mindfulness, without apparently noticing that the study excluded generic mindfulness-based interventions and looked only at specific Buddhist meditation practices.
It reported that 82% of people questioned had experienced fear, anxiety or paranoia, without making it clear the study only interviewed people with negative experiences. It also said that people who had previous psychological problems had been "ruled out" of the study. Yet the study reported 32% of people interviewed had a history of psychiatric disorder (only people with current mental illness, or similar unusual psychological experiences not linked to meditation were excluded).
Finally, the Mail said the study interviewed "nearly 100" people about their experiences, when they actually interviewed 60 people.
What kind of research was this?
This was a qualitative study. Qualitative studies, like this one, use interviews to ask people open-ended questions about their experiences of specific issues, such as meditation.
Experiences were then grouped into categories. The researchers looked specifically for people who'd had negative experiences of meditation, because they say these experiences had not previously been properly investigated.
This type of research is useful to gather detailed information about people's experiences. It doesn't tell us how common these experiences are, what causes them, or why these people in particular experienced them.
What did the research involve?
Researchers recruited 60 people who were regular practitioners of one of three types of Buddhist meditation, and who had experienced a challenging or negative experience linked to meditation.
They interviewed them about what they experienced, how they understood it, and what effect it had. They also interviewed 30 "experts" – mostly meditation teachers – about their understanding of what caused challenging experiences and how they could be managed.
The interviews were used to compile models of types of experience (described as "domains") and models of the factors that could affect people's likelihood of having this type of experience. Researchers say this element should only be understood as the opinions (often conflicting) of the teachers and experts interviewed, not as a definitive list of causes.
What were the basic results?
Researchers identified eight "domains" of experience from the interviews, which included both positive and negative experiences. These were:
- Cognitive, or related to thinking. This included changes in world view, delusions, irrational or paranormal beliefs, mental stillness, and change in the way people made decisions to do things (executive function).
- Perceptual, or related to information from the senses. This included hallucinations, visions or illusions, seeing lights and being more sensitive to sensory stimuli such as noise or bright light.
- Affective, or related to emotions. This included fear, anxiety, panic or paranoia, which were the most commonly reported group of challenging experiences; feeling blissful or very happy; depression or grief; re-experiencing of traumatic memories.
- Somatic, or related to body. This included feeling bursts of energy, changes to sleep patterns, feelings of pain, and both increased or released pressure or tension.
- Conative, or relating to motivation. This included changes in motivation, change in effort, loss of enjoyment of things usually found enjoyable and loss of interest in doing things.
- Sense of self, which included feeling a loss of boundaries between self and the rest of the world, a loss of sense of self.
- Social, which included difficulties in interacting with people, especially after returning from a meditation retreat or period of intensive practice.
Of the practitioners interviewed, 60% were also meditation teachers, and 41% of them said their challenging experiences followed meditation of 10 hours a day or more. This suggests they were more intensive practitioners than the average person doing perhaps half an hour a day.
The researchers said the experiences were likely to be caused by meditation, as they'd passed criteria designed to assess causation. These included whether they happened at the time of the meditation practice, whether they were linked to more intense practice, whether they receded when people stopped meditating and returned when they began again, and that they were consistently reported by people in the study.
Some experiences were directly caused by meditation, while others might be secondary – for example, fear at loss of sense of self – or even tertiary – for example distress at the way they were treated by a meditation teacher after having a challenging experience.
How did the researchers interpret the results?
The researchers say the results suggest that "meditation practices – on their own – may produce challenging effects, but the specific type of effect, as well as its likelihood, duration, and associated distress and impairment, is influenced by a number of additional factors."
They add that the results "should not be interpreted as conclusive" because the study is one of the first in its field.
Conclusion
Many people around the world find meditation can be helpful. However, as with most things, there can be downsides.
Some people – especially if they practice intensive meditation for many hours, such as on a retreat – have challenging or difficult experiences. Some religious teachers within Buddhism say these can be part of the path of the religious experience. However, for people doing meditation hoping to experience health benefits, without a religious context, these experiences can be unexpected and difficult to deal with.
There are limitations in this study that mean we shouldn't try to apply it too widely. The people interviewed were quite a select group – all had volunteered to talk about challenging experiences during meditation, the majority were meditation teachers, they were almost all white and highly educated (42% had a master's degree and 25% a doctorate). Their experiences may be different from those of the average person attending a meditation class or using a meditation or mindfulness app on their phone.
The serious, long-lasting nature of some of the negative experiences reported, however, are cause for concern. People who experience depression, suicidal feelings or other serious problems after meditation should seek medical help.
