Mind the hype
During the last two decades, meditation – led by mindfulness, its public face – has burst out of obscurity to saturate both the news and scientific literature, as the graph shows.
The Headspace app – one of the most popular, offering hundreds of guided meditations – has been downloaded by over 65 million people in 190 countries. Type “mindfulness benefits” into a search engine, and first-page results include “23 Amazing Health Benefits of Mindfulness for Body and Brain”. One effervescent article claims, “Mindfulness can help to reduce stress and anxiety and conflict, and increase resilience and emotional intelligence, while improving communication in the workplace.”
But have its positive aspects been oversold in the flurry of attention? Mindfulness can be sold as a universal panacea for the ills of modern-day society – or a toxic workplace – when the practice can vary from five minutes on an app to weeks of silence in an isolated setting, producing a wide range of physiological and psychological results.
And there’s been little thorough examination of negatives, despite a study as far back as 1979 by pioneering meditation teacher Jack Kornfield, who helped introduce the practice to the West. He looked at participants in a three-month vipassana meditation retreat, and recorded “strong negative emotions, involuntary movements, anomalous somatic sensations and out-of-body experiences”.
This lack led to a 2020 meta-analysis in Acta Psychiatrica Scandinavica led by the UK’s Coventry University’s Miguel Farras, touted as the “first systematic review” of meditation adverse events (MAEs), covering 50 years of research – and one that can lead to a “less hyped and more objective standing” for the practice.
There’s historical detail in there, including meditation being used by soldiers in Imperial Japan from the 1890s to 1945 to enhance their killing power, and the long-known malady known as “meditation sickness”. This is described as a “paralysing state of self-absorption” resulting from focus on the present without engaging with Buddhist teachings. Eighth-century Indian master Kamalisa warned it would lead to beings spending 500 aeons after death as mindless zombies.
Thankfully, the meta-analysis failed to unearth any mindless zombies. But given that adverse affects run at about the same rate as in other psychotherapies – 3 to 10 per cent – many more meditators than expected might be experiencing negative outcomes.
The study defined MAEs as “harmful or distressing”, occurring during mental practices bringing focus to a particular object, or to the flow of conscious awareness. They cut a list of 6742 studies to 83 deemed rigorous enough for analysis, including 57 measuring prevalence.
In 54 experimental studies, 59 of 2673 people had MAEs; for 14 observational studies, that was 1012 of 4023. The pooled prevalence of MAEs was about 1 in 12, running at 1 in 30 for experimental studies and 1 in 3 for observational studies.
The most common reported symptom was anxiety, at about one in three, followed closely by depression, cognitive anomalies including thought disorganisation or amnesia, stress or tension, hallucinations, and psychotic symptoms.
There wasn’t enough information for the researchers to study individual factors for MAEs, though most subjects didn’t report a history of mental health disorders. They suspect that MAEs are being under-reported, which might also explain the huge difference between experimental and observational data.
But it is notable that the most reported MAEs, such as anxiety and depression, are those that meditation is supposed to treat. Explanations – including those undergoing the events – include that these are barriers to growth which are ultimately helpful to overcome; the intensity of the meditation practice, such as multi-day vipassana retreats – and teacher competence.
There’s also the role of perspective. Experiencing the loss of a sense of self, for example, might seen as a plus from a religious framework, but as a minus on a personal level.
This nuanced approach to the experience of MAEs – and their surprisingly high prevalence – can be seen in a study to be published in full on February 12 in Psychotherapy Research. Of 434 lifetime meditators, one in three nominated a general item on a list of adverse events, with one in two choosing at least specific condition.
The most common reported symptoms were anxiety, trauma re-experience and emotional sensitivity, with one in 10 being depressed for longer than a month. However, having an MAE didn’t put them off meditation.
And in an article in Mindfulness last year, Bhikku Analayo warned that drawing attention to possible negatives of mindfulness shouldn’t replace “the mythisation phase” with “the demonisation phase, in which it will be stigmatised as something too unpredictable and hazardous for clinical purposes”. He thought some problems were caused by teachers tweaking ancient practices into overly “hardcore” approaches to be healthy.
Good news, everybody
The fact that there is a journal called Mindfulness, stuffed with mindfulness studies, confirms how ubiquitous the practice has become. And one particular study into changing perception about political polarisation – namely, being in favour of or against Brexit – shows its positive potential.
The 52-48 vote in favour of the United Kingdom leaving the European Union convulsed the country, splitting families and friendships, and transformed its political landscape with many working-class pro-Brexit Labour constituencies voting Conservative.
A group of researchers wanted to see if mindfulness could alter the significant “affective polarisation”, or feelings and perceptions, that Leavers and Remainers had about each other. The lack of mutual respect and ability to discuss political differences could threaten a functioning democracy.
They recruited 177 students at the University of Oxford, including 38 EU citizens, for an eight-week online course adapted from a 2011 book on mindfulness, which has been used in the UK Parliament. (No word on whether its politicians liked each other more afterwards.)
The 90-minute classes included meditation exercises and interactive segments based on cognitive behavioural therapy – and covered topics such as “waking up to the autopilot” and “practising kindness”.
Those practising mindfulness showed “significantly greater reductions” in polarisation compared to the control group, and it “may lead to sustained and generalised changes in attitudes towards outgroup members”.
Next week: the effects of mantras on the mind and body.